HomeMy WebLinkAbout820615_INSPECTIONS_20171231NORTH CAROLINA
Qepartment of Environmental Quality
o pliance Inspection Operation Review
Reason for Visit: ®'Routine 0 Complaint 0 FoUow-u 0 Referral 0 Emergency
Region: f«O Date of Visit: I?-..~ llff.(/8 Arrival Time:! f/t! "ltllf I Departure Time:J j/i ca A I County: r.Jv.f-11,(
Farm Name: ;g-e<.J b'1 -ryn t,J( _ Owner Email:
Owner Name: ~) ,l( i. ~"1. t gtlV'-'6-"'Vf cr.-cJ..c:.[/ Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Integrator: ·f V'-f!.Sf..~K
7
Certification Number: / f/J-3
~~----------------
Onsite Representative: 1
{
Certified Operator: _ZC:_· ...;..6'1..<=--· .!::..l)~-L-...!f;.;....;...._;:;..._{L....f'(-"{....:::.....:£.=-.{,/___:;._{ ______ __
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? DYes Wo DNA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other:
a. Was the conveyance man-made? DYes 0No .0}NA ONE
'
b . Did the discharge reach waters of the State? (Ifyes, notifY DWR) DYes 0No [J-'NA 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~ LJNA 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 I of3
DYes o
DYes r . No
DNA ONE
DNA ONE
21412015 Continued
I Facility Num"ber: I Date of Inspection: J;a ; fl( /81
Waste Collection & Treatment
4 . Is storage ca pacity (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):
Observed Freeboard (in): 3 I -----
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 ~NA ONE
DYes 0No ~ONE
Structure 5 Structure 6
DYes ~o DNA O NE
0 Yes {]?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 s tructures need maintenance or improvement?
8. Do an y of the structures lac k 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 s tructures require
maintenance or improvement?
Waste Application
DYes
DYes
DYes
DYes
[9'No DNA O NE
r::(No DNA ONE
~0 DNA ONE
I
(]!No DNA ONE I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. DYes ~ 0 NA 0 NE
0 Excessive Ponding D Hydraulic Overload D 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 Application Outside of Approved Area
12. Crop Type(s): i3 ~ .. Atl{AJ-L S' ~-()
13. Soil Type(s): /1J'1 /3/ w vt.P--1. 1'{aru '(V/
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 . 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 CAWM P readily available? If yes, check
the appropriate box.
0WUP Ochecklists 0 Design 0 Maps 0 Lease Agreements
DYes []}No DNA
DYes [JJ1'lo DNA
DYes ~0 DNA
DYes (d'No DNA
DYes ~0 DNA
0 Yes ~0 DNA
DYes cttNo D NA
Domer:
ONE
ONE
ONE
ONE
O NE
ONE
ONE
2 1. Does record keeping need improvement? If yes, check the appropriate box below. DYes []'No DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Weathe r Code
0 Rainfall DStocking 0 C rop Yield D 120 Minute Ins p ections D Monthly and I" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install a nd maintain a rain gauge? 0 Yes [!fNo 0 NA 0 NE
23. lfselected, did th e facility fai l to install and maintain rainbreakers on irrigation equipment? D Yes ~o 0 NA 0 NE
Page 2of3 114/2015 Continued
IF~cility l'I,_Jdber: g' a.= ,z; I 5 ] I Date of Inspection: Q-o 1Jfv-~
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes [d.-No 0 NA 0 NE
25. Is the facility out of compliance with pennit conditions related to sludge? If yes, check 0 Yes Q.-NO 0 NA 0 NE
the appropriate box(es) below.
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)
3 I . Do subsurface tile drains exi st at the facility? If yes, check the appropriate box below.
D Application Field 0 Lagoon/Storage Pond 0 Other:
32 . Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
-
0 Yes ~0 DNA ONE
0 Yes ~ DNA O NE
0 Yes [AlJilo DNA ONE
0 Yes [f}No DNA ONE
0 Yes ~ DNA ONE
DYes ~ DNA ONE
DYes G""No DNA ONE
DYes (6'No DNA ONE
DYes ~0 DNA ONE
II-3rv -17
lr .~ 5o -1 7 F-7. 2
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
Phone:'f( olf3 3-J .33 i
Date: &:-'i.J Jf\."l.·l l g
1/411015
ompliance Inspection Operation Review 0 Structure Evaluation
Reason for Visit: ~outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Denied Access
Date of Visit: lltt ~ M I Arrh·al Time: I f}D~ p Departure Time: IJ;Pt? P I County: S f1-V4 Region~
Farm Name: ~ a..So"\ T'(l{.fA£/ Owner Email :
Owner Name: .....~etd::....L:t ({.:....:\~~;_~~"---=..::B...;..~_"'....::{p_'bL....:.....::;_-...&..(_,i....:.;..t:....:.~~·f __ _ Phone:
Mailing Address:
Physical Address:
Facility Contact: ....l~~=rl"....:+....:("""'s;.___~_a.._g...:.{;J_cvlt __ Title: Phone:
Integrator: p ( t'5 s~
Certification Number: ....~{~8-...~(..:Z.:;;.J"------
Onsite Representative: [(
Certified Operator: _.:f.....Jo~Q.:~o..,f~CM....J.....__./.:.~·----'-j;-J'/:....;~;.......:----------
/
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 ~D NA O NE·
Discharge originated at: 0 Structure 0 Application Field 0 Other:
D Yes 0 No 0'NA O NE
0 Yes 0No 6 NA ONE
a . Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume th at reac hed waters of the State (gallons)?
d. Does the discharge bypass the waste management system ? (If yes, notify DWR) 0 Ye s 0No GNA ONE
2. Is there evidence of a past discharge from any part of th e operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other tha n from a discharge?
Page 1 of3
0 Ye s
0 Ye s
[2f'No DNA ONE
@ No DNA ONE
21412015 Continued
I ,
!Facility Number: ~ -fO/.S .J if_ I Date of Inspection: /~ 44"' r r I
• Wastt-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):
Ob served Freeboard (in): P-1
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
0 Yes 0 No
DNA ONE
~A ONE
Structure 5 Structure 6
DYes [d')No 0 NA 0 NE
DYes [!(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
ma intenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes CEJ"o
0 Yes {3'No
0 NA ONE
DNA ONE
0 Yes (LfNo 0 NA 0 NE
DYes DNA ONE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes
~0
~0 D NA 0 NE
0 Excessive Ponding D Hydraulic O verload D Frozen Ground D 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
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12 . Crop Type(s):
13. Soil Type(s):
14 . Do the receiving crops differ from those designated in theCA WMP?
I 5. Does the receiving crop and/or land application site need improvement?
16 . Did the facility fail to secure and/or operate per the irrigation des ign or wettable
acres determination?
0 Yes
0 Yes
DYes
DYes
DYes
DYes
DYes
00ther:
0 Yes
u;;}No DNA
~0 DNA
~0 DNA
[3'No DNA
~0 DNA
[3'No DNA
Cf'No DNA
f.21' No
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Page 2 of3 21411015 Continued
\ ..
!Date oflnspection: /C ~;y..(f11 !Facility Number:
4 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 [Z).;.ro DNA 0 NE
DYes~ DNA ONE
D Failure to complete annual sludge survey D Failure 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 provide documentation ofan 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? lfyes, check the appropriate box below.
D Application field D Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance ofthe 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?
GJ~u-~f '~ {D-f)..__o-r 5
si c._tzr e_ se{ ~ .... t J--?--7 -r 6 -6-3.f-
DYes [3'No DNA ONE
DYes ~0 DNA ONE
0 Yes ~0 DNA ONE
0 Yes @No DNA ONE
DYes [21'No DNA ONE
0 Yes [LfNo DNA ONE
D Yes []"No 0 NA 0 NE
DYes U(No DNA ONE
DNA ONE
Reviewer/Inspector Name: -B l1 ( ~
Reviewer/Inspector Signature : __ i~'-'e(,.~UJ~-~~_.Q=~~_,_--------------
Page 3 of3
Phone170 Jt33-~fS f
Date : 1/t>-qbJ -a 3J ~
21412015
Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: <:irlioutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Ill moPj {'{,Arrival Time:l/ ~00 PI Departure Time:!/ i 'i b A County: ~A-:'11.. Region:~
Farm Name: w~ 5'~ ~~>~t.At( Owner Email:
Owner Nameo ltJ, U /'"-""-t ~ 77tii1JJ Phone:
Mailing Address:
PhysicaiAddr~s: --------------------------------------------------------------------------------------
Facility Contact: C~ts Ba ~'c.{( Title:--------Phone:
Onsite Repr~entative: ___ ....,:l~:..l.:...._ ________________ _ Integrator: PV'-c..5 M-
Certified Operator: "7J' ((.~h.. L 71~ Certification Number: { f' /2..,)
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharg~ and Stream Impacts
I. Is any discharge observed from any part of the operation? DYes ~DNA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other:
a. Was the conveyance man-made? DYes 0No crNA ONE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No ~ ONE
c. What is the estimated volume that reac hed waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No [31t\ 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
~ DNA ONE ~ DNA ONE
21412011 Continued
I
l -1 r::IF=-ac-:-i:-:-lity:N--:-. =-u-m:-be_r_: --4f'!Jrl~r--_---,GI+I::fr.,l I Date of Inspection: 'j VUAi:/6
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):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not proper ly addressed and/or managed through a
waste management or closure plan?
DYes ~NA ONE
DYes 0 No ~ ONE
Structure 5 Structure 6
DYes ~o DNA QNE
0 Yes [9-tfo DNA 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 n:4uired by the permi t?
(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 B-M'o DNA 0 NE
DYes~ D NA ONE
0 Yes D,No D NA 0 NE
DYes~ DNA ONE
11. Is there evidence of incorrect land application? Ifycs, check the appropriate box below. D Yes Q.Wo 0 NA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground D 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 Approved Area
12. Crop Type(s): §(!lr~(/ gG D
13 . Soil Type(s):
14. Do the receiving crops d iffer from those des ignated in theCA WMP?
15. Does the receiv in g c rop 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.ls 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?
DYes
DYes
DYes
DYes
DYes
DYes
0 Yes
CJ-No D NA
GI"N~ DNA
[d"N o DNA
~No DNA
[31'l o DNA
CfNo D NA
~0 D NA
ONE
ONE
ONE
ONE
ONE
ONE
ONE 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box .
OWVP 0Checklists 0 Design 0 Maps D Lease Agreements Oother: _________ _
21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes ~o 0 NA 0 NE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analys is D Waste Trans fers 0 Weather Code
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections D Monthly and 1" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ll] No 0 NA 0 NE
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes [j' No DNA 0 NE
Page 1 of3 11411014 Continued
I ; ?1/llit· /(; !Facility Number: I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~0 DNA ONE
DNA ONE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes ~0
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:
DYes ~0 DNA ONE
DYes ~0 DNA ONE
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 DYes g1io 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? 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 ~0 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 [B"No DNA ONE
D 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?
DYes r::;rNo DNA D NE
DYes (2('No DNA 0 NE
DYes ~No DNA ONE
Comments (refer t~fquestion .#):~~~jplaiJu~ny~YES answers andf.or any adc:liti~ft.,!!,~ei.:~mmendations or any,:ijl!j:£_~i~~!'Oielits.
Use drawings of facility to better explain sitUations (use additional pages as n'~es~lff.:y). · :~~_::-:f'fSr{:::~ ..
Cttl~~l~-(o-~-IS
~~ ,. f 1--'-'2-/ (S b -... 3.5
Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature:
Page3 of3
Date: ~4~ l~ --~--~,~-~--------
11412014
Date of Visit: 1~3 MMJ6f' Arrival Time: I g'rc?6 r
Farm Name: f '(cA-.4£{ r/§ 1. t/
Departure Time:l.j~ ~ f I County: 5i1-wL
Owner Email:
Owner Name: t..J i ({ f ~ -ry~{J Phone:
Mailing Address:
Physical Address: (6,1 o..--..fc.. • S'" £v:I'W f c..k
Facility Contact: f { Title: ---------------------Phone:
Region:~
Integrator: P CCS~f
Certification Number: {Cf / ~ J
Onsite Representative: tl
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field
a. Was the conveyance man-made?
0 Other:
b . Did the discharge reach waters of th e State? (If yes, notify DWQ)
c. What is the estimated volume that reach ed waters of the State (gallons)?
Certification Number:
Longitude:
DYes ~NA ONE
DYes DNo ~ ONE
DYes DNo [J""RA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes DNo ~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?
Poge 1 of3
DYes
DYes
[3--Ntl DNA ONE
~0 QNA ONE
11412011 Continued
•
[Fii"cftity Number: I Date oflnspection: ::Z 3 /l6.; ( t;1
• 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):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~DNA ONE
DYes 0 No l3l'f1'r D NE
Structure 5 Structure 6
0 Yes EJ-Mt> 0 NA 0 NE
DYes (3""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 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?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~ DNA ONE
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 D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Type(s): ~&~ ~ G<>
13. Soil Type(s):
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. 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 CAWMP readily available? Ifyes, check
the.appropriate box.
OwUP 0Checklists 0 Design D Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes ~DNA ONE
DYes~
DYes [J'No
DYes ~
DYes ~
DYes rr(
DYes ~
Dother:
DYes lti" No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
0 Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? D Yes !Z{No 0 NA 0 NE
23.lfselected, did the facility fail to install and maintain rainbrcakers on irrigation equipment? DYes E:('No 0 NA D NE
Page2of3 21412011 Continued
IFadtity Number: I Date of Inspection: -9\3 · ~I
• 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 s ludge? If yes, check
the appropriate box(es) below.
DYes~ DNA ONE
DYes ~DNA ONE
0 Failure to complete annual sludge survey 0Failure to d evelop a POA for sludge leve ls
0 Non-compliant s ludge 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 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 faci li ty fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
DYes
D Yes
D Yes
DYes
DYes
DYes 31 . Do subsurface tile drain s 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 or CAWMP? DYes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 0 Yes
34. Does the facility require a follow-up visit by the same agency? 0 Yes
[9-NO DNA
~DNA
~ DNA
~ DNA
[j"No D NA
~DNA
[3-No DNA
~ DNA
~ DNA
u~ ~ .J-,.,.... co-p-:-1 3
5\~~l( l ~~ '1--l '1 -o-3 u ll r-;, t
Reviewer/Inspector Name:
Reviewer/Inspector S ignature:
Page 3 of3 21412 011
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Compliance Inspection
CYRoutine 0 Denied Access
Date of Visit: I cqL\\ia I Arrival Time:IO~'.W~I Departure Time:llOtOO pr.V'\ I County~AAf!SOO Region: fRO
Farm Name:\ 'i,N fNp. \_ 't\~ ~ C.nx.c.kl'. l:PJ\ri\ Owner Email:
Owner Name: W:u,~~ -r ~ N,t\'-\L L.
(
Phone:
Mailing Address:
Physical Address:
Facility Contact: ~~So\\ t~~O(:\\\ Title:
Onsite Representative: ____::§.=-..:::~:!..C!'t:........::-----------------
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
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)?
Phone:
Integrator: S>B~~~
Certification Number: ....~:f;....;Cf:...;t~l::::..::~=------
Certification Number:
Longitude:
0 Yes [B'No DNA ONE
DYes DNo 152f'NA ONE
DYes DNo &f'NA ONE
d. Does the discharge bypass the waste management s ystem ? (If yes, notify DWQ) DYes DNo i2(NA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impac ts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I ofJ
DYes
DYes
~0 DNA ONE
j0'No DNA ONE
1141201 I Continued
....
IFa~ility N~mber: ~~ 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 structural freeboard?
Structure I Structure 2 Structure 3 Structure4
Identifier: ~:1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No
DYes ~No
DNA ONE
DNA ONE
Structure 5 Structure 6
DYes g"No DNA ONE
D Yes [g'No D NA D NE
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 ofthe 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?
DYes gNo DNA ONE
DYes ~o DNA ONE
DYes ~o DNA ONE
DYes ~No DNA ONE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. DYes ~o 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
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): c(!J~S.\.(:\L ~~Q..~uo~ 'N\-=t I ~ (rCJ
13. Soil Type(s): \'1\.A\l. v.:tl'\ ) Uffi,i...~~ '
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?
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 D Maps D Lease Agreements
21 . Does record keeping need improvement? If yes, check the appropriate box below.
DYes §'No DNA ONE
DYes [g'No DNA ONE
DYes [S!(No DNA ONE
DYes [S?No DNA ONE
DYes g1./o DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
Oother:
DYes !2r'No DNA ONE
0 Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers 0 Weather Code
0 Rainfall D Stocking D Crop Yield D 120 Minute Inspections D Monthly and l" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? DYes 8"No DNA D NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? D Yes ~No D NA 0 NE
Page 2 of3 21412011 Continued
IFa~ility Numher:
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 jg'No 0 NA D NE
0 Yes [g"No 0 NA D 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 as sessments (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.
D Yes [g""No
DYes [S'No
DYes [2fNo
DYes ~o
DYes ~No
DYes ~No
0 NA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
0 Application Field D 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?
0 Yes ci"No
0 Y cs [}J"No
0 Yes D{No
DNA ONE
DNA ONE
DNA ONE
\1~~~:~~~J~~!~r t~:~~~!J.i~~~J~~-pla~n a~y ~s linswcrs ~n.dfor,~(~rJ.~d~itio.-.al recommcnd!lti~ns~:~r a,!lr· ~!_lie Usc~arawmgs ·offaclltty ·to ·b.~.-tcr,explam Situations (use add1honal:pages as necessary). · --_ :: .
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of3
Phone : ~&' .. l,og S \
Date: '-\ \ ~ \'7r
' 214/2011
Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: @'Routine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: t7/lt I J 1 I Arrival Time:ft~{)).AR I Departure Time: ItO,' 1?/flq I County: S:tnfStb Region: Fpt}
Farm Name:~~~·~±~ Ch!t~ib lilce, }~(
Owner Name: ~~ I r nd (I
Owner Email:
Phone:
Mailing Address:
Physical Address: .....,.,~-=----------------------------------------·~.5 . 'P':l
FadUty Contact: \o.jfrfv., • Jj nJa /L T;tle: M~
Onsite Representative: _\D~Oc~~lhL..:..._}l....J..f.7..Llnd~f!~l ..... f _________ _
Certified Operator: '\ta )(;r 1j nda 1/
Phone:
Integrator: p ( fdgj e_
Certification Number: _,}~9~/ d_=3 _____ _
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? DYes ~No 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? (If yes, notify DWQ) DYes 0No DNA ONE
c. What is the estimated volume that reached waters of th e State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) QYes 0No DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were th ere any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Pagel of3
DYes
DYes
jBNo DNA ONE
18'No DNA ONE
2/4/1011 Continued
IFacilitfNumber: 'n ).. !Date of Inspection: i" 7/ld /1
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 Structure2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): t,.i Q
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 DNA ONE
0 Yes 0 No 0 NA D NE
Structure 5 Structure6
DYes j3No DNA ONE
0 Yes ~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 DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures Jack 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
IO . Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
~Yes 0No DNA ONE
DYes fi(~No DNA 0 NE
0 Yes 1!0 No 0 NA 0 NE
0 Yes fSj("No 0 NA 0 NE
11. Is there evidence of incorrect land application? If yes , 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. 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 Approved Area
12. Crop Type(s): CtJo.Jltr) ~ea, vd/),. tky; Sh'tl/~1in OV~l~r-J_
13. Soil Type(s): . Hor'f' )s Hac; W1J10?1 I { h~ 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?
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 of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box .
OwuP Ochecklists 0 Design 0 Maps 0 Lease Agreements
DYes
DYes
0 Yes
DYes
0 Yes
l)fNo
~No
lg"No
tsa"No
liS) No
0 Yes ~No
0 Yes ~No
Oother:
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 Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 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 18J No 0 NA 0 NE
23. Ifselectcd, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes D No rsa NA D NE
PagelofJ 21412011 Continued
IFacilit)-NunitJer: ~.}.. I nate of Inspection: 7/11/ f 1
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25 . Is the facility out of compliance with penn it conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes (8-No D NA 0 NE
QYes ~o DNA ONE
0 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 of first survey indicating non-compliance:
26. Did the facility fail provide doc umentation of an actively certi fied operator in charge?
27. Did the facility fa i l to secure a phosphorus lo ss 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 fa ci lity pose an odor or air quali ty 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)
0 Yes ~0 DNA ONE
DYes 0No CiNA ONE
DYes I)S1 No DNA ONE
DYes !)a" No DNA ONE
DYes ~No DNA ONE
DYes "5aNo DNA ONE 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? 0 Yes 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
R<viewe<llns pocto< Nam'' ~ ~.~
Re viewer/Inspector Signature: __ \Jo~:....'h....;..L___;:$=(;}J~.:...Oue....L..J eurL-----------------------------
Phone : q /trl/23-33/X> /fl6it)
Date: Jidv l/, ~ 0 II ffi. J PageJo/3 '411011
Type of Visit ~Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Region: FRQ Date ofVislt : RJ~IIO I Arriva1Time:I'6;3QAt1 I D epartureTime: lq~l?l\!1 I County: SO~ttfS<i'l
Farm Name : 11Jndal/ ~ q_ CJJicke Eat~4 OwnerErnail: -----------
OwnerNa me : ~lltfon 't Tyndq/1 Phone:
Mailing Address : -----------------------------------____ _
Phys ical Address:----------------------------------------
Facility Contact: \ra.Jib 1J n. dol/ Title: ---------Phone No: qqo=Lfl-O'f
Onsite Rep r esenta tive: _'\t .......... ""'o~' .... £h'-l,-1j..,...n ..... d .... fl ........ l .... l________ Integrator: Prei~ e
Certified Oper a tor: "J'm<b -l~)'f''n..u.dol!..a~l.,_J______ Operator Certification Number: ... 1 ..... 9'""/...;::~.,3..._ __ _
Back-up Opera tor: --------------------Back-up Certification Number :
Location of Farm: Latitude: D OD 'D " Longitude:
Discharges & Stream Impacts
1. Is any discharge observed fro m any part of the operation? D Yes ~o D NA O NE
Discharg e ori g in ated at : D Structure D A pplication Fie ld 0 Other
a. Was th e con veyan ce man-made?
b. D id the d is cha rge reac h waters of th e S ta te? (If yes , notify DW Q)
c . Wh at is the estim ated vo lume that reached waters of the State (gall ons)?
d . Does d ischarge bypass the waste manage ment system? (If yes , noti fY DWQ)
2 . Is th ere evid ence o f a past disc ha rge fro m any part of the opera ti on?
3 . We re th ere any adverse im pac ts or pote nt ia l adverse impacts to the Waters of the Sta te
other than fro m a d ischarge?
Page 1 of3
D Yes 0 No
D Yes 0 No
DYes 0 No
DYes l:a'No
D Yes ~0
12128104
D NA O NE
DNA O N E
]
DNA O NE
D NA O NE
D NA ONE
Continued
:.
jFacill~Number:~;} -€f5" I Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall ) le ss than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: f .J:>.("
Spillway?:
DYes ~o DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
De signed Freeboard (in): __.\._Cf..._ ___ -------------------------------
Observed Freeboard (in): _y..::...t-..,.0'-----------------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes ~0 DNA ONE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properl y addressed and/or managed DYes tij:'No 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)
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
DYes ~o DNA ONE
DYes ~o DNA ONE
DYes 5{No DNA ONE
11. Is there evidence of incorrect application? If ye s, check the appropriate box below. DYes t)I:No 0 NA D NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D 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 Ac,eptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s?1fft m~'o/.sc,
13 . soil type(s) Wa B' BoB· HoC-\s
7 J
14 . Do the receiving crops differ from those designated in the CAWMP? 0 Yes ~No 0 NA 0 NE
15. Does the receiving c rop and/or land application site need improvement? D Yes 18'No 0 NA 0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? 0 Yes ~ No 0 N~ 0 NE
17 . Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewerflnspector Name
Reviewer/Inspector Signature:
Page 1of1
0 Yes .lS'No DNA D NE
DYes ~No DNA ONE
Continued
I FaciJity Number: %d. -<0121 Date of Inspection I 91~ 'til() I
Required Records & Documents
19. Did the facility fail to have 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 . 0 WUP 0 Checklists 0 Design 0 Maps 0 Other
DYes ~o DNA ONE
0 Yes 1St-No 0 NA 0 NE
21 . Does re cord keeping need improvement? If yes, check the appropriate box below. ~Ye s 0No DNA ONE
0 Waste Application 0 Weekly Freeboard 5ii-\Vaste Analysis D Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall D Stocking D Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~0 DNA
23. If se lected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes 0No ~NA
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~0 DNA
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes IS(No DNA
26. Did the facility fail to have an actively certified operator in charge? DYes ~o DNA
27. Did the facility fail to secure a phosphorus lo ss assessment (PLAT) certification?
Other Issues
DYes INo v~NA
28. Were a ny additional problems noted which cause non-compliance of the permit or CAWMP?
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?
33. Does facility require a follow-up v isit by same agency?
Ms-tvOte.-J(norrT)
DYes 18-No DNA
DYes ~No DNA
DYes ~No DNA
DYes ~0 DNA
DYes BNo DNA
DYes ~0 DNA
l,s+; ll o,e. \orje_ hue. sror 01 'badtsfde_ C!tf JaJoo". R-estvt· 1~00\ hPJ ~ ooci . C.OJPr
::<1.vvos/e ~~h11a\y5rr qof -f1~ tJo" ~ooq-~e_ ;;,o,o. Sane..e.~~~~p:m,
d01t \~ t1£Vc~ o" tJoJt.,bfr Yl"-11 )')er_s bvt PAAJ lS not-eve" c{oJe -ftf be,
VJed uf 1
Pie~ siJ" off-:tt.lt ~ a+ f!ul of.St'tUCYJ
OvfrO)\J:JOOd. Joo~~ fo,"' q_!Joetl re(cr/J. r .• •
· o{_ _j r ...-~-'-"a~~ l/\riaHtt!---(&-Sv~~~tswt-sleanc~ Cl.. }Joe 1)01 01 ?'oa"'w .._ofy -J(n~ '' · g flvNlb~ ore tttiT 1tt Cdont>dl'tl\, a rend 'J +of rod vue r
Pag e 3 of 3 12118104
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
.Facility No.~(plr
Permit J' COC
t-1 ~q_CA/Ct"'
Farm Name \~ndal\ ti lt?J Date ____ _
_., OIC_ NPDES {Rain breaker
Pop. Design Current
Type
Lagoon 1 2
Spillway
Design freeboard Uo
Observed freeboard (in)
Sludge Survey Date lUJiRlfH
Sludge Depth _(ft) 3J/J
Liquid Trt. Zone (ft) 7r!.J
Ratio Sludge to Treatment Volume
Calibration Date 1 lci 1~1/(J:; 2 3 4
Design Flow lc'D). /{:])'
Actual Flow /6if. lbY:
Design Width ~1~15:
Actual Width 1.-Aiy:[jf({J ldi"F d
/
Soil Test Date j' /~'( ll 0 Wettable Acres __ _
pH Fields h-5 -7
Lime Needed /uO
WUP
Weekly Freeboard __tL_
Lime Applied
Cu-I '-"""zn-1~
1 in Inspections ...........-
120 min Insp. , L
NeedsP ~ Weather Codes ~
Crop Yield Transfer Sheets nt,
Waste Analy_sis Date q 1-;:,J /I() lf;/tl/0 Jlld3!00
-60 Day
+ 60 Day 4/~ leo I} ~)/09
N Amt {lb/1 000 Gal) } .... _d. ~--3 t . //1\59)
pH (fl#~
I
Pull/Field Soil Crop Acres .fb-N
1-4-'t'VaiJ .()P--h-d~ (\,l(p _.J .i--.
/\.rJT
~· J)o(7 ~--~dJ
b--{~ ~0.~ /\-'de .~ JnO
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 3000== 1081b/ac; Zn-1 3000= 213 lb/ac
....._
PLAT Annual Cert)
I I I I
3 4 5 6 7
5 6 7 8
~UGE \../
~or incinerator ~
Mortality Records ~ '"'~ ~le~
Window Max Rate Max Amt
:rio O<G f-0
App. Hardware
Type of Visit ~Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit : f6/~ Of I Arrival Time: jl/~J0-4111 Departure Time: 110; 3oAfil County: SI/Wf.lfh Region:F/20
Farm Nam., Jy1 ~11 4 S' 0, Owner Email:
Owner Name: ~~lr-T;nda/j Phone: -----------
Mailing Address: -----------------------------------____ _
Physical Address:----------------------------------------
Facility Contact: VbJl?J IjndaU Title: .:...Hu:®~IJjq.:...ft~-----Phone No:-------
Onsite Representative: VoJ t>l ry rda (I Integrator: .p, erfcy e._
Certified Operator: "'\t? 1Xb __,Ti~T._.n .... d......:;Ja ..... / .. J_____ Operator Certification Number: fA . .....:.:..~.14....~...-....:.l....~9....~.:/J........,3:::;...__
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes &No DNA ONE
Discharge originated at: 0 Structure D 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)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge rrom 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 0No
DYes 0No
DYes 0No
DYes NNo
DYes ~0
11/18104
DNA ONE
DNA ONE
]
DNA O NE
DNA ONE
DNA ONE
Continued
....
· §Cffity Number~s). -{Gft) Date oflnspection lB I ~i/12 ~
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 Structure4
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifi er:-----------------------------------------
Spillway?:
Designed Freeboard (in): _ __.1 ..... ~+--------------------------------------
Observed Freeboard (in): __ 3.....L.OQ~-----------------------------------
5. Are there any immediate threats to the integrity of any of the s tructures observed?
(ic/ large trees, severe erosion, seepage, etc .)
DYes .QNo DNA O NE
6. Are there structures on-site which are not properly addressed and/or managed DYes
through a waste management or closure plan?
2-No DNA O NE
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 st uctures lac k 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 a lternatives that need
maintenance/improvement?
EYes 0No DNA ONE
DYes lia-No DNA O NE
DYes 5;!-No DNA O NE
DYes R'No DNA ONE
ll. Is there evidence of incorrect application? If yes , check the appropriate box below . 0 Yes ~o DNA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy M etal s (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/S ludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area
12 . Crop type(s) Cob/la I f>e,..c.da f!o/ J s G or
13. soil type(s) BoB s ' HaC \s '. 'rvaB iS
J J
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 detennination?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
l8No
~0
~0
'18No
~0
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Re,iewer/lnspec:tor Name
Reviewer/Inspector Signature:
DNA
DNA
DNA
DNA
D NA
ONE
ONE
O NE
O N E
ONE
Date of lnspedion ~~~~~lor I
Required Records & Documents
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 appropriate box . D WUP D Checklists D Design D Maps D Other
·--. ·-:;
DYes 8-No DNA ONE
0 Yes [SI-No 0 NA 0 NE
21. Does record keeping need improvement? If yes , check the appropriate box below. DYes ~o 0 NA 0 NE
D Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Annual Certification
0 Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes l);J:No DNA
. 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes D No (S}NA
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes [S;(No DNA
25. Did th e facility fail to conduct a sludge survey as required by the permit? DYes §-No DNA
26. Did the facility fail to have an actively certified operator in charge? DYes ~0 DNA
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 0No ~NA
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes· l2$N'o DNA
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes
and report the mortality rates that were higher than normal?
~0 DNA
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA
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 EtNo DNA
General Permit? (ie/ discharge, freeboard problems, over application)
0 Yes 'li;a-No 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DNA
33. Does facility require a follow-up visit by same agency? DYes ~No DNA
7, Pre~e mvfc11 One.la--,e blf'e.rebt<fJ hactt!fo(e off~ -fbt..,.,a(f.l ClbPd-Ct~nf.&t
· 4. PleBJe.. C/1 II bra/e! +ht's ye11r.
I B"od foolc!J -thr,., ~oa:L recods.
12/28/04
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
.. ' ....
Facility No. ~d-b(): Farm Name -~~y'-'-n~Jc=q._,_J.._/ ~..!....5=fhL..f---Date ____ _
..._.,/ I Permit ./ COC ____ OIC_ NPDES (Rainbreaker PLAT Annual Cert }
Pop. Type Design Current FB Drops
I I I
b 't\
/
~
·~ ~ ( f/Al.
Lagoon 1 -L 3 4 5 6 7
Spillway
Design freeboard
Observed freeboard (in 20 ;:;;L'"') ~3
Sludge Survey Date 1 n J;:,~lrn
Sludge Depth ft) & %
Liquid Trt. Zone (ft)
(;)f) \Of.IY
Calibration Date l-(rl)-I(J/ 2
Design Flow lr~<;
Actual Flow bl
Design Width ~~
Actua I Width ~yO
soil Test Date iorr~~ ~~~~
pH F1elds
Lime Needed l/07
Lime Applied
Cu ~Zn ~
Needs P
Pull/Field Soil Crop
1-"1 \llm n
5 go_p,
b-tl t1 aQ
A II }),/fs
'
~. /
~-<&
1-U
3 4
Crop Yield ~lq
Wettable Acres __ _
WUP -.,.../'
Weekly Freeboard~
Rainfall > 1" _......-
1 in Inspections __
RYE PAN
So m! }-:;)_-,)
~0-lYS ;>'{ 1
)~b~ 3tJO
so
Verify PHONE NUMBER,.S and affiliations ·
Date last WUP FRO a IOJ....,-Urtf.J1'. Date last WUP at farm
FRO or Farm Records
Lagoon#
Top Dike 4()tj
Stop Pump :)/,~..}
Start PumP, 3Cf, 'b +-
Aff'pJ.fty \')nLVa1-J~ f~i
5 6 7 8
120 min Inspections V""""
Weather Codes ~
Transfer Sheets ~
RAIN~UGE
(Qead ~ or incinerator __ _
~ll /'
Window Max Rate Max Amt
~-lLt-O.G j.l()
I
Sf£1-Hp.., ,_
' /
App. Hardware
I
.. ....
Type of Visit 0"tompliance Inspection 0 Ope r ati on Review 0 Structure Evaluation 0 Technical Assistance
Reason for V isit 0 Routi ne 0 Complai nt 0 Follow up 0 Referral 0 Emergency er0ther 0 Denied Access
Date of Visit: l"i-z-o91 Arrival Time:! 't . 0 0 I Departure Time: II I : 0 0 I C ounty: s-ay~ Region: E'i< 0
Farm Name: --ryab/1 r;i:.~l Owner Email : --------------
Owner Name: --u.B~·~' .~'1;'-'o-?,.__.....,T.__ __ ~77...,Y'--A.,.~~ ..... ~~~% ___ _
Mailing Address: V 43 I N U S '-1¢.1 tlw ~ L / i nP ~
/
Phone:
A) C.
Physical Address:----------------------------------------
Facility C ontact: ___,1«'-='-5.1-'0~Yl-'---_ _,_T-.....,· v~_,_Yl..:..).""""'tt;...cf+/--Title: f~;,-,_ l1f,, ~ rr" 7 II
Phone No: c; /o-990-'tSt:l!f
Onsite Representative: ------------------Integrator:----------------
Certified Operator:--------------------Operator Certification Number: -------
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Str eam Impacts
l. Is any discharge observed from any part of the operation ? D Yes iJ No D NA O N E
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)?
d . Does discharge bypass the waste management system? (If yes, not ify DWQ)
2. Is there evide nce of a past discharge fro m any part of the operation?
3. Were there any advers e impacts or potenti a l adverse impacts to the Waters ofthe State
other than from a discharge?
DYes D No D NA O NE
D Y es 0 No D NA O NE
D Yes 0No D NA O NE
D Yes OJ.No D NA O NE
D Yes ~No D NA O N E
1212810-1 Co ntinued
~ .. J Facility Number:~ -/piS J Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy ra infa ll) less than adequate ?
a. If yes, is waste level into the structural free board?
Structure 1 Structure 2 Structure 3 Structure 4
DYes ~No DNA ONE
DYes ~No DNA ONE
Structure 5 Structure 6
Identifier:----------------------------------------
Spillway?:
Designed Freeboard (in): _ ___.1~.--~.J ___ ------------------------------
Observed Freeboard (in): _ _..\. ... }.,b'"""""'--------------------------------------
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 addres sed 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
10. Are there any required butTers, setbacks, or compliance alternatives that need
maintenance/improvement?
0 Yes bZINo DNA D NE
DYes ~No DNA ONE
DYes l)(~No DNA ONE
0 Yes 0No DNA ~NE
II. Is there evidence of incorrect application? If yes , check the appropriate box below. D Yes 0 No D NA 121 NE
0 Exces sive Ponding 0 Hydraulic Overload 0 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
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outs ide of Area
12. Crop type(s) -----------=-----------------------------
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CA WMP? DYes DNo
15. Does the receiving crop and/or land application site need improvement? DYes 0No
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination?O Yes 0No
17. Docs the facility lack adequate acreage for land application? DYes 0No
18. Is there a lack of properly operating waste application equipment? DYes 0No
Comments (refer to question#): Explain any YES answers and/or any recommendations or any other comments~
Use drawings of facility to better explain situations. (use additional pages as necessary):
12128104
DNA (XI NE
DNA ~NE
DNA 6?:)NE
DNA ~NE
DNA ~NE
Continued
I -..
I Facility Number: a-~ t51
Reguired Records & Documents
Date of Inspection I 2-2-0'
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 readi ly available? If yes , check
the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other
DYes gjNo DNA ~
D Yes g[ No 0 NA r;d{tf
21. Does record keeping need improvement? If yes , check the appropriate box below. DYes 0 No 0 NA ~ NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste T ransfers 0 Annual Certification
D Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain In spections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes 0 No DNA ~NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes 0 No D NA ~NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes D No D NA ~NE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes D No D NA ~NE
26. Did the facility fail to have an actively certified operator in charge? DYes DNo D NA ~NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes DNo DNA ~NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes DNo DNA ~NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes 0 No DNA ~NE
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
If yes, contact a regional Air Quality representative immediately
0 No DNA [!NE
31. Did the facility fail to notifY the regional office of emergency situations as required by DYes 0 No DNA laNE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-s ite representative? DYes ~No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE
. -.
Furl'/1,,-w.,~ aJv.c.-) T5 C'D""'..$# .5·~~ ~J .5Jt:i'~;/i..2..~.:1ro ·-/.s~·??,_J
Cot&~n 17--, CJ/I .. o;;.lv 914. .,_____ -"".,;L tvt!J~ ..£~'1--r-w.-7-4_ ,..~ 1 ..L
/ C.I!Y?7/Hr-,ncf111Lh7l""J
~ ~h!Jcr--...
~ v;Lf 1d t;r/.,_, c~1~ c;PA't:..c t,_Ut:L_s .5'PnTTr'c ktr,....J cF rl~ of,·fc'
a-uo/ TZ; /) -JI~ w~ .5~ /VO c.t»-u--nL;~-~ · _'I _ .J . -;y· c. !.S-5&~ ~ ·U/•''"lt1 l1t; ~ -Fc;I'JI'Vt.
Page3 of 3 11128104
Type of Vi s it ~Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~ Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Dat e of Visit: L4'tLI.JI::.I..::~...J ArrivaiTime:lq; WJtPtl Depa rture Time: llr.,3oAf'JI County: ~,PJih Region:F Je-0
Farm N a me: ....!~~-~,d~..LIJJ~t.pV.:...;.:1JVJ:..:. ~----l---11 :..;; I-!::J~I'3::;;._ _______ _ Owner Email: -------------
Own erNa me : ~ qfj~ 5yrcL I Phone:
Mailing Address: ----------------------------------------
Physica l Address :----------------------------------------
Fa cility conta ct: 'Pavrcl( 9ynl. T itle: _tJ=-.:,.~_n:....loe..L..r______ Phon e No : ______ _
Oosit e Representative: p;r\rjc;t ~y rJ_ Integrator: ...;f1......_......,8""-------------
Certified Operator: J().e j) -~~,J.'""-=-------Operator C e rtifica ti on Numbe~: If... A J qg II../
Back-up Operator: 'J":ohn -? _,,,.,.d_..IL..!:=--------Back-up Certifica tion Number: _AtvA J 90(, 7
Location of F arm: D OD'r--1 " Latitude: L..J Longitude:
Discharges & Stream Impacts
I . Is any d ischarge o bserved fro m any p art o f the operation?
Disch arge ori ginated at: D Structu re D Applicat io n Fi e ld 0 O th er
a. Was the conveyance man-made?
b. Did th e d isc harge reach waters of the State? (If yes, noti fy DWQ)
c. What is the estimated volume tha t reached waters of the State (gall ons)?
d. Does di sc harge bypass the waste manage men t system? (If yes, noti fy DWQ)
2. Is th e re eviden ce of a pas t di scharge fr om any pa rt of the o pe ration?
3. Were there any adverse impacts or potenti a l adverse impacts to th e Waters of the Sta te
oth er th a n fro m a disc harge ?
0 Yes 'lia'No D NA D N E
D Yes 0 No D NA O NE
D Yes 0 No D NA ONE
I
DYes 0 No D NA O NE
D Yes g No DNA O N E
D Ye s !)No DNA ON E
12128104 Con tinued
\ ....
Date of Inspection
Waste Colledion & Treatment
4. Is storage capacity (structural plus storm storage plus heavy minfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
D Yes ~o DNA O NE
D Yes D No DNA O NE
Structure 5 Structure 6
Identifie r:-----------------------------------------
Spillway?:
Designed Freeboard (in): _.~..J '1 .......... ____ ____.l_'l...._ ___ ....:,.l_'f'----------'-1 <=f....__ __ ----------
Observed Freeboard (in): _::::::3._'3~----~3~lf+-------::~:.....l!!W~-------'Y.u8"~..~--__ -----------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes fiaNo DNA O NE
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes )J"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 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
10 . Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes iSJNo DNA O NE
DYes l'$(No DNA D NE
D Yes ~N o DNA O NE
DYes 18'No DNA ONE
11. Is there evidence of incorrect appli cation? If yes, check the appropriate box below. D Yes ~o D NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.}
0 PAN D PAN > 10% or 10 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area
12. Croptype(s} COh:kl &lh~~ &i/ve '.S6 OJ
J
13. Soil type(s) W1 B IS ' GoA 15
7
14. Do the recei ving crop s differ from those designated in theCA WMP?
15 . Does the receiving crop and/or land application site need improvement?
D Yes f2No DNA ONE
K)Yes 0No DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?O Yes DNA ONE
DNA ONE
DNA ONE
17 . Does the facility lack adequate acreage for land application'!
18 . Is there a lack of properly operating waste application equipment?
DYes
DYes
Comments (refer to question#): Explain any YES answers and/or any recommendations or any other comments.
Use dra\\ings offacility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone:~~-:~-==:......::=~~=C/
Date:
...•
I Facility Number~;)._ -<R (J I Is-
Date of Inspection lbll'f10f I
Required Records & Documents
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 ENo DNA ONE
21 . Does record keeping need improvement? If yes, check the appropriate box below . DYes ~No 0 NA 0 NE
0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to in stall 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 penn it?
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 nonnal?
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?
33. Does facility require a follow-up visit by same agency?
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
~No DNA ONE
0No r:ilNA ONE
~No DNA ONE
~No DNA ONE
~No DNA ONE
0No [S(NA ONE
fia"No DNA ONE
~0 DNA ONE
i2J'No DNA ONE
gNo DNA ONE
~0 DNA ONE
~0 DNA ONE
l, Tree5 'rvf/e,. DFv~hfJ o..;f 0'\ I f(Jo01 3
15'1 Need_lfme. fYt sfttJ.J -0e/Js, err/{, .~ b..fh, ~
Also l!feJ-to Sfld.f .sf~t!&frcldo-()!) I Aq.IB. Cvrr '/be:::; ::9.
frler+o s&ra,ftj' 43~-:t>osaJ
;;)), lttjco, 4 hod.. .slvtf1e. deoneJ od-Nov d008 (stnce-I tlJi-slvr/Jesv~).
L~(X)') ~ hal,asl"~ -to ir~ votv/)1-e of ~ t~r~o-~ill not-n-eeJ...clea,Dv-f-
~ se~Q~ ~etts.
Go:d_~hl. ~welt ~-e[+'f'ecoJJ ..
Vole$,~ o, ~rod~tr c ory~ 0o~ sittlft( vml Ia~ oo-fo reviev ~lJJe cletr~ofreunh-' ~ ;rtfk clekl L
Oafe '"'Or ertO,eo~ J,\W a.r 0/ ltf-, o, frodl..fEr Cof
Page 3 of 3 12128/04
. . ..
;acility No. ~;)-(? P
Permit .../ COC
Farm Name -~-~-r'i~d:l....J0-.L....;v:.....::J--"'B'-IY'----Date ____ _
./ OIC_7_ ( NPDES (Rain breaker
Desi n Current I FB Drops I I I
Lagoon 1 2 3
Spillway
Design freeboard ' '
Observed freeboard (in
SludQe Survey Date 1=1\tO!«
Sludge Depth (ft) & % I
Lig_uid Trt. Zone (ft) \ 15.~
Calibration Date 1Q 14/~ 2 3 4
Design Flow
Actual Flow
Design Width
Actual Width ;nO
Soil Test Date yl tJlO£( Crop Yield ..I\Jiy02((
pH Fields Wettable Acres
Lime Needed ~ l:a T(/15/ Ac--WUP ---
Lime Appli~d , '
12
L-. Weekly Freeboard .....=::::::_
Cu _v_ zn ~ ~w.> rJ:tl's leN Rainfall > 1" _.,.-
Needs P ~~~ 1 .in Inspections __
Pull/Field Soil r ..... .&rop RYE PAN
1-:) Waara"" 'ttA: ·n _-&t'Ji' V ••· ,, "-~~
'1 (.;}{A l(iJ.J{J 1-p ~:>1
l4c.-~E M !Ol7ul r~ ~(}.)
htl l506~ )DO
~b ?0
Verify PHONE NJ,U.(IBERS and affiliations
Date last WUP<EB9 crlt I Oy Date last WUP at farm
@9 or Farm R~o~s ':)_ 0
_I_ Lagoon# · 5U~
Top Dike 10 1· ')0.{) ~S-0
Stop Pump q"), '3 Llvo '-N .D ifl .. o
Start Pump ~fj.). u~,() ~0~ ~4 .. 00
~
I 1<g 5JJ;d .. v;': ').0 ;).0 .
..,,..,
~,v ·.
4
fc.n) ,
5
Window
11u-~n. .,
Ocf .-Hcv
PLAT Annual Cert )
I I
5 6 7
6 7 8
120 min Inspections
Weather Codes
Transfer Sheets
RAIN GAUGE
Dead box or incinerator
t1 aia\~ -v-
Max Rate MaxAmt
Od:; I, o
(),')
~ /
\J
...
r r • •
Type of Visit ~Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: 191fa\ Q! I Arrival Time: 19PSAf1 I Departure Time: lfB~OiAt'] I County: Sa.,ps"' Region : FR(}
Farm Name: T1tt.dal{ 4Sil') Owner Email: ------------
Owner Name: B fJ4t_ ~nb U Phone:
Mamng Addm" J{;, N l?.s ~ a.1 :iJ!!l _;;C=.,:I~i'aitn.L.L.K..I~.-______ 0>~8
Physical Address:----------------------------------------
Facility Contact: "\t4J~ TyaJ.qlf Title: CQ.ovlltr' Phone No:-------'----
Onsite Representative: -:f4JP1 Ty nda II Integrator: -~"--'-'re=--i-;;;&;....pe...-..:::;.... ________ _
Certified Operator: )'w&l Tt,nJo U Operator Certification Number: ANA JqJd)
I
Back-up Operator: Back-up Certification Number:
Location of Farm: D O JI'D" Latitude: L__J D OIJ• D" Longitude: L__J
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D 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)?
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 impac ts to the Waters of the State
other than from a discharge?
Page I of 3
. ,, .. : • ,·_ .: . ·• ~-. -... _;.!;;:.. ·-~:-. - -.....
DYes 'T)}No 0 NA D NE
DYes 0No DNA ONE
DYes DNo DNA ONE
DYes DNo D NA O NE
DYes fiS No DNA ONE
DYes ~No DNA ONE
11128/04 Continued
··(Facility Number:~d_ -k{L I Date oflnspection 1~15'" 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
DYes riJNo DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier: ---+L-------------------------------------
Spillway?: l; '(
Designedfreeboard(in): _ _,l'-'f~---------------------------------
Observed Freeboard (in): _.::;a.:...;f~;.-___ ------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes '1:81 No DNA ONE
(ie/ large trees, severe erosion, seepage, etc.)
6 . Are there structures on-site which are not properly addressed and/or managed DYes r.8'No 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)
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 butTers, setbacks, or compliance alternatives that need
maintenance/improvement?
15lYes 0No DNA ONE
DYes l)lNo DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
11. Is there; evidence of incorrect application ? If yes , check the appropriate box below. DYes lif"No DNA 0 NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn , etc.)
0 PAN D PAN > 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manu re/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(•) Coma l ~ .. ~ #a. ·.S"' oS' -----.._ /J
13. Soiltype(s) BoB '5 m. I.5·HZC rr
)
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 determination?D Yes
~No
~0
~No
17. Does the facility lac k adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/1 nspector Signature:
Pagel of 3
DYes 'fit No
DYes ~o
DNA
DNA
DNA
DNA
DNA
ONE
ONE
ONE
ONE
ONE
· · I Facility Number:~ :J. jo(£ I Date of Inspection lq;Ja, ... Oi I
Reguired Records & Documents
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. D WUP D Checklists 0 Design 0 Maps D Other
21. Does record keeping need improvement? lfyes, check the appropriate box below.
DYes ~No DNA ONE
DYes !R-No DNA D NE
DYes 15l-No DNA D NE
D Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections D 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 pennit?
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 t ime of the inspe ction d id the fa cility po se an odor or air quality c oncern?
If yes, contact a reg iona l Air Qual ity repres entative im mediatel y
31 . Did the fac ility fail to notify the reg ion al office o f e merge ncy situations as requ ired by
General Permit? (i e/ di scharge , fre eboard probl ems, over application)
32. Did Re vi ewer/In spector fail to di scuss review/inspec ti on wi t h an on-site re pres enta tiv e?
33. Does facilit y require a follow -up visit by same agency?
DYes ~No
DYes 0No
DYes A(~' No
DYes ~No
DYes ~No
DYes 0No
DYes ~No
DYes ~No
DYes ~N o
DYes gNo
DYes SNo
DYe s ,EJ No
7, ~lfl!e.. rvtvf< lNl Ot\€-bao-e.. SffJT On i"rlJe.. bac~t. tara II uP-I '!JOf¥l~ Mo.rt t*-
\~tnt! h1.s eKcell~~st-C().Jfl·
w-e 1\ rn 1 hl.tl'n-AL -fN ~tt tNvJ. r e r ords.
Pa ge3 of 3 12118104
DNA ONE
~NA ONE
DNA ONE
DNA ONE
DNA ONE
i)NA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
-•
.,.,
• · · Facility No .~;)-~!';;-Farm Name \y nJ11J/ q. _\Ll:-J
Perm it __ COC __ _ OIC_ NPDES (Rain breaker PLAT Annual Cert )
Pop . Type Design Current I FB Drops
I I I
Freeboard 1 2
Design
SIMS
Observed (in) 'J."
Sludge Survey Date Perm liquid (ft) "7.'Y
~l)Oitn Sludge Depth {ft) ~..,.
Calibration Date 1 Qlrltn
Des ign Flow '",.-Actual Flow lb7
Spray Flow
Design Width ;)tf"
Actual Width . ~
Soil Test Date II !01 -aff'Oi'.
pH Fields __
Lime Needed
Cu v-Zn :7
NeedsP--~
2 3
Crop Yield
Wettable Acres
WUP
Rain Gauge
4
/
07
v
Weekly Freeboard ..,...-
Rainfall >1" /
3
Waste Analysis Date ~~~' -OWf1 hftoc~~ Ot~.-ln.. \ .. athl~' '-Q,.,
-60 Day ' I
+ 60 Day
N Amt {lb/1 000 Gal) =:)-,
pH ~·Dr
Pull/Field Soil Crop
1>fl 111vJ11 -=it2 1 se:, --iA/m .P I
J ·-
4
5
Pan
l"?r-:Joo
:;-o
5 6
6 7
1 in Inspections
120 min Inspections
Weather Codes
Transfer Sheets
Window
~A--M
y p-/1u1
" /
7
8
ll ·-BBo · ~PM t1Dt O.h/hr
il+ 'i" hrTo'ltil /tb'~fC ~~" ~ 31 ~1.:1 -rr~t i kfrt \'J~t~( 1/L ~ D.in:J~-n' MQ -F~ or CJvb ~ twryrtt~ ~~ge D:bli ·€t;JL r ~ ~Ftot\ ~ ~ N~Jf~nC +
. 'fil Division of Water Quality :-b \ \(\ S
'Eacility Number (~;l. _HwL~ 11 0 Di\·ision of Soil and Water Conservation . \ 1 c{6
0 Other Agency ""\ ~ Q'1 ·
Type of Visit ~ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 11 /~tJIJ11 Arrival Time: I j 3 J I Departure Time: 1{6 30 I County:...~~
'
Region:i=t:D ,
Farm Name: lbQlf.g II rJ Snn Owner Email: -------------
Owner Name:-----------------------Phone:
Mailing Address: ----------------------------------------
Physical Address:~~--------------------------------------
Facility Contact: ~ ~ cf.a // Title: Cc ~owner=
Onsite Representative: =x; SOn '§ada f /
Certified Operator:J 4.$ID"' :Jtj n Ca 1/
n~::O.;h;p
Integrator: __ V::......:II_; ~~::::;:a'-Q-==!!1!1~---------
0perator Certification Number: __../_~..;......:/:....d=......,J,__ __
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD 'D " Longitude: D OD 'D"
. . ,. Design Current : Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
-~10 Wean to Finis h I I I 10 Layer I ·-·· . I . . .. I_: F-O~D;...;;a~iry-....;;;..C..;;..ow __ +-----~-----1; ::i D Wean to Feeder O Non-L aye1 _ . _ _ . 0 Dairy Ca lf i ~~eeder to Finish I~~ ~ ~<fto =..:...:.::::..:....;:..::.o...;;.:.....---'-......,., _ _....~.,-_,...,=--~ F-O~D;....;a;;.;.iry~J-..;;.;Ie;;.;.ifi;..;;.el_-+---t-----41
·.' D Farrow to Wean Dry Poultry 0 Dry Cow
}~ 0 Farrow to Feeder 0 Non -Dairy ·.. 0 Layers F-O~~;....;;;;..;;;..;..;..,o'---t----+------l i '~ 0 Farrow to Finish =:::-=:;J....;;.:..:::...--+---~~--~ Beef Stockel i ;~: D Gilts F.:O~N...;..o;;..;;n'--""La""'lY'""~e.;;..;rs~t-----+----t : 0 Beef Feeder
';: D Boars 0 Pullets F-0::;.-;:B;..;e;..;;c...;..f ..;;..B..;;.;ro;..;;o;..;;.d.;.....C_o_lw+-----i-----1
-·· ·· -··· ·--··-,.-· 0 Turkeys J 'Oth'~r ' . . ,_ 0 Turkey Poults
4 ~,;;:1.Q=-...;;..O, __ .;.;;th,;.;;er""'----=--'""'· _ ___.I..__ __ L-1 __ ___.!' D Other Number of Structures: CZJ.
Discharges & Stream Impacts
1. Is any di scharge observed from any part of the operation?
Di sc harge originated at: D Structure 0 Appli cation Field D Other
a . Was the conveyance man-made ?
b. Did th e discharge reach waters of the State? (If yes , no tify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Docs di scharge 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 potentia l adverse impacts to the Waters of the State
other than from a discharge?
D Yes ~o D NA ON E
DYes 0 No R!/NA O NE
DYes 0No .J3 NA O NE
I
D Yes 0 No~A ONE
DYes ~o DNA ONE
O YevhNo D NA ONE
11128104 Continued
..... Date of Inspection ~ I Fa~ility Nbmber~ _:) -GJ/S: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 l Structure 2 Structure 3 Structure 4
0 Yes ';iflNo DNA 0 NE
0Yes ~o DNA ONE
Structure 5 Structure 6
Identifier: ______________________________________ _
Spillway?: ~A
Designed Freeboard (in): ---r:::::.-1-( 4-~-~L ;----:: 5::-/w~~¥/'-----------------------
Observed Freeboard (in): 3 3 ~ ....qt!r ~0
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?
0Yes~o 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? 0 Yes ~No 0 NA 0 NE
8. Do any of the stucturcs 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?
0Yes~o DNA ONE
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes !lVNo DNA 0 NE
l L Is there evidence of incorrect application? If yes, check th e appropriate box below. DYes t(No DNA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN > 10% or lO lbs 0 Total Phos phorus 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) ~much
13 . Soil type(s) l.Ua_8
14. Do the receiving crops differ fTom those designated in the CA WMP? DYes ~o
15. Does the receiving crop and/or land application site need improvement? DYes ~No
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?D Yes ~0
17. Does the facility lack adequate acreage for land application? DYes $No
18. Is there a lack of properly operating wa ste application equipment? DYes ~0
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
------~~~~~~--~~~~~~~'--------------
Reviewer/Inspector Name
Reviewer/Tnspector Signature:
Phone:
Date:
DNA
DNA
DNA
DNA
DNA
ONE
ONE
ONE
ONE
ONE
Date of Inspection ~
Required Records & Documents
I 9 . 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? ff yes, check
the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other
DYes )'No D NA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? ffyes , check the appropriate box below. 0 Yes ~No 0 NA D NE
D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking D 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?
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 appli cation)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does faci lity require a follow-up visit by same agency?
DYes ~No
DYes ~No
DYes tllNo
DYes ~No
DYes ~No
0 Yes )!lNo
DYes ~No
DYes ElNo
D Yes _..fQNo
DYes ~No
DYes ,fit No
D Yes kJNo
DNA ONE
DNA ONE
DNA ONE
D NA O NE
D NA ONE
D NA O NE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
·:r~~:-:·:-.:~··}~: :~ ~~~}~-t~~~~~-··_:t.~
Page 3 of3
-+o.J:.Q LP._S 6()"'
I""~/) +D Oc/ 31
11128104
..... -
-•
~ . ~acility No. &J (o / ~ Time In 9 6/ TimeOut__ Date 'l/A/~7
Integrator /?//.£flo~/ 1 ::.~~;rs
Operator :::Ca. So-n. ~~k,J J.U
Back-up
coc_
Wean-Feed
We::an Fini~h
c ~eed ...... Finish "")
Farrow-Wean
Circle: . ~eneral1 or
Design -current
I
SliW _(n~lo
S~eRep ____________________ __
No. lCJ Jd-.3
No
NPDES
Design Current
Farrow-Feed
Farrow Finish
Gilts I Boars
Others
FREEBOARD: Design __ J~...-'1_---=~ {620 ~~ ~
~ ~::·~;=~ ... , L/ -;.?/
Soil -r:~~t~-=--~--PLAT \. .. /
Observed _________ _,
Cali brn!ic!"!/GPM ·~ ! l W 7
Waste Transfers ) -
Rain Breakef......, -'----
Wettable Acres ' _.
Weekly Freeboard ~ Daily Rainfall -------1-in Inspections ____ _
Spray/Freeboard Drop -----------------------
~~~K__J-, Weather Codes __ _ 120 min Inspections __ _
Waste Analysis:
Date Nitrogen (N) Date Nitrogen (N)
.
t-:f»_uii/Field Soil Cro2_ Pan Window -· I () . -'"' n IL ....... -....... ( . ---n'-:-'t-lA.h)::> '"")(? 1 fn t.U6 _{)._ tT di'S f. Y -~r -UC-j ..,_~
·~ 25m &)r o 1 <\ ~ _,,~
J y u
/l 0
I::\ ~-0_ /)o/!S -..........
(_~-[1-N1 r ~
! I' lY\ '---
~·
f
Type of Visit @-COmpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
I Departure Time: IJ;_ ... , $" I County: ' , . Region: z=iirV Date of Visit: I z-;o'M Arrival Timed//: t>O
Farm Name: T:jA-?Ia/f r/:...SZP--Owner Email: --------------
Owner Name: 13; I J v TY&:Ja/1 Phone: r ~
Mailing Address: _Ce~'£~~~....~....1_...:::U=.$"--.....,~""~=-,_I _.J.}J _____ -"C.=L:.....r:' r-L' n-..::.-:t'll~~:.....=;.. __ .!,_JI/___;_C....::....___~n..,;L..JV
Physical Address:------------------------------------____ _
Facility Contact: (/ii.sen-= Tytzdal/ Title: ------------PhoneNo: ________ _
Onsite Representative: _2~::;~..::~::==--------------Integrator: ?/z-:-s~r:
Certified Operator: ---=./c::;....;;~......;..~.-..--------------Operator Certification Number: ) ?lt:?-3
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude: D OD'D"
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field D Other
a. Was the conveyance man-made?
b. Did the discharge reac h waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters ofthe 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 advers e impacts to the Waters of the State
other than from a di sc harge?
Page 1 oj3
DYes i&l.No DNA ONE
DYes J&lNo DNA ONE
DYes ~No DNA ONE
DYes iZJ_No DNA ONE
DYes l&l.No DNA ONE
DYe s ~0 DNA ONE
12128/04 Continued
Date of Inspection 12---Lo-~4
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?
. S tru cture 1 Structure 2 Structure 3 Structure 4
D Yes 1;8.No 0 NA D NE
D Yes ~No D NA O NE
Structure 5 Structure 6
Identifier:----------------------------------------
Spi llway?: Vz",:S
Designed Freeboard (in): __
1
..._!::-?4----------------------------------------
Observed Freeboard (in): _d"'" ...... ~..__ ___ -----------------------------------
5. Aie there any immediate threats to the integrity of any of the structures observed? DYes !&No DNA O NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there s tructures on-site which are not properly addressed and/or managed DYes j8J No DNA ONE
through a waste management or closure plan?
If any of question s U were answered yes, and tbe s ituation p oses an immediate public bealtb 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 require d by the permit?
(Not appli cable to roofed pits, d ry stacks and/or wet s tacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
D Yes ~No D NA O NE
D Yes ~No D NA O NE
D Yes fiaNo D NA O NE
10 . Aie there any required buffers, setbacks, or compliance alternatives that need 0 Yes )ZJ No D NA D NE
maintenance/improvement?
11 . Is there evidence of incorrect application? If yes, check the appropriate box below. D Yes BJ No 0 NA 0 NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN D PAN> 10% or 10 lbs D Total Phosphorus D Fai lure to Incorporate Manure/S l udge into Bare Soil
D Outside of Acceptable C ro p Window D Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s) .lSr:rJn u /4 1/7 ,I t911«...£r-d.tfoy t?cG?;? ;z.. e
13 . Soi l type(s) Wa 13 j :JS o 71 /m4t?
14. Do the receiving crops differ from those designated in the C A WMP? D Yes ~&(N o D NA ONE
15. Does the receiving crop and/or land application site need improvement? D Yes ~No O N~ ONE
16. Did the facility fai l to secure and/or operate per th e irrigation design or wettaSle acre determination ? DYes Jiq No 0 NA 0 NE
17. Does the faci li ty lack adequate acreage for land application?
18. Is th ere a lack of properly operating waste application equipment?
Reviewer/lnspectorName I..Wv--r::::..... b~~
Reviewer/Inspector Signature: ~ ///
Pagelof3
DYes ~N o DNA O NE
DYes llJNo DNA ONE
I Phone: 9-/o -lf:J J -:r J J,;L
Date: 7 -I t>-d-\>0 \....
12128104 Continued
·~
.l . .. I Facility Number: 4CJ:-bldr" Date of Inspection I :ZI () -DQ
Required Records & Documents
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 appropriate box. D WUP D Checklists D Design D Maps D Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes ~No DNA ONE
DYes 2i-No DNA D NE
DYes g]No DNA ONE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification
0 Rainfall D Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and I" Rain Inspections D 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 rain breakers 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 ofthe 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?
33. Does facility require a follow-up visit by same agency?
Page3of3
DYes !J,No
DYes 8fNo
DYes IZ]No
DYes 5?J. No
DYes R!No
DYes [5{No
DYes ~No
DYes ~No
DYes ~No
DYes ~No
DYes ~No
DYes 18No
12118104
DNA
DNA
DNA
DNA
DNA
DNA
DNA
DNA
DNA
DNA
DNA
DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
...
1--
1--.....
Division of Water Q" n,.,,,.,, •.. ,
·· -Division of Soil and "'·~•.,.,,;..r•;...,..
. . <Age~c~. ·.··
'·.
0 Operation Review 0 Structure Evaluation 0 Technical Assistance Type of Visit 8 Compliance Inspection
Reason for Visit • Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
DateofVisit: l~/~.:!o/orl Arrival Timed I~ ;.,lo I Departure Ti me: L..l ___ _...l Cou nt y: -~~r-~~,.J Region: J=="RO
Farm Name : --1-y-n.c/d.i( : .5~m ~f ,._., 1-<f Owner Email: -------------
Owner Na me: ~ ~~ clo..J ~ _e_; ll.t-htn~ // Phone: _lfiD -S'Y I. -L> .33 ~
Mailing Address: '3 3 ~ CeJ..o..r._L~kc_L~c. _ _,e""""_;_;Vft,~_u(J ;;J ~ .SJ..l-
Physical Address: __3'~4>.V £C:.( ( : ,,0 ~ «to ~ 4./ Sb'f_ ____________ _
Facility Contact: --------------Title: -----------Phone No:---------
Onsite Represe ntati\·e: ::::s=a..>~-~=---"'-'1-~-lt,______ Integrator: Pr-~.J..::~~'fr«-=--------
Certified Op erator :--=:)~ ),o--> -'~-""·o!c:.:::;...\,_\'------Operator Certification N umber: __ (_q___:_I_..;J._,.,3.._ __
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD 'D " Longitude: D OD 'D "
'f~~~~~
~H D W ean to finish
¢~
~· : D Wean to Feeder ,.
~-~
·.:.~
• fil Feeder to Finish
~: D Farrow to Wean .~
'~ , D Farrow to Feeder
·, D Farrow to Finish
,DGilts
'D Boars --· --··--··-· -
Design . Current
Capacity Population
5Bi'IJ 5.2_9_~,..
. .. .. ·-····
I· I
Discharges & Stream Impacts
Wet Poultry
I ID La yer
Dry Poultry
D Layers
D Non-Layers
D Pu ll ets
D T urk eys
D Tu rk ey Poults
0 Other
I. Is any discharge observed trom any part of the operation?
Des ign
Capacity
Current
Population
D ischarge orig ina ted at: 0 Struct ure D Appli cation Field 0 Other
a. Was the conveyance man-made?
b. Did th e disc harge reach waters of the State? (If yes, noti fY DWQ)
Cattle ·
. .· Design Current
... ·· · .. Capacity Population
D Oai_ryCow
D Dairy Calf I:
· D Oai_ryHeife1 '
D OryCow
D Non-Dairy i
' D Bee f Stocker t
D Beef Feeder
D Beef Brood Cow
·-·· --. ·--'-....
Number of Structures: ,'CIJ.
D -Yes ~No D NA O NE
DYes D No D NA O NE
DYes DNo D NA O NE
c. What is the estimated volu me th a t reached wate rs of the State (gallons)?
d. Does di sc harge bypass th e waste manage men t system? (If yes, not ify OWQ)
2. Is there evidence of a past discharge from any part of the operati on?
3. Were thcre .any adverse impacts or potentia l adv erse impacts to th e Waters ofthe State
other th an from a di sc harge?
DYes DNo
D Yes {J No
D Yes l11 No
12128104
D NA O NE
DNA O NE
D NA O NE
Continued
Date of Inspection (C, ),23 li'ff
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 riNo DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier: __ ...;;~;:../L~-· __ ---------------------------------
Spillway?: t1 Vo 4-c.-9:J:...__ _________ ----------
Designed Freeboard (in): ----=~:..2e;.o.:l_-•_• __ ----------------------------------
Observed Freeboard (in): -~;3""-"'3._1_' __ -----------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes ~No DNA ONE
(ie/large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed DYes {1No 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 ~No DNA ONE
0 Yes llJNo DNA ONE
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
DYes Q;!No 0 NA ONE
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
D Yes f¥J No D NA 0 NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes mNo DNA 0 NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN 0 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 D Application Outside of Area
12. Crop type(s) /Jerrn IA.Ja.c ,1/4"( / 5 C -0 ~
13. Soil type(s) /4)4 ~ frl<& C
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 fail to secure and/or operate per the irrigation design or wettable acre deterrninationiD Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
£1-o.;J "fvu <.-1-i! ;.,oL ~ f
.-,~v .C~~.
~t-11
DYes
DYes
Reviewer/Inspector Name ~;_;_~:..!:::..:;.;~~~~~~;...:;;*~__.;.;:..:.:;2.::::..;::..:i;!:!!:!!!~!:!~~ Phone:
Reviewer/Inspector Signature: Date:
r,EINo DNA
!1iNo DNA
rJ1No DNA
~No DNA
~No DNA
ONE
ONE
ONE
ONE
ONE
12/28104 Continued
§my ~:mber: S'.l. -'1Si Date of Inspection I /;/»frrl
Required Records & Documents
19. Did the facili ty fail to have Certificate of Coverage & Permit readil y available?
20 . Does the facility fail to have all components of theCA WMP readily available? lfyes, check
the appropirate box. 0 WUP 0 Checklists D Design D Maps D Other
DYes ~No DNA ONE
DYes CBNo DNA ONE
21. Does record keeping need improvement? If yes , c heck the appropriate box below . DYes I:E No D NA D NE
0 Waste Application 0 Weekly Freeboard 0 Waste Anal ysis 0 Soil Analysis 0 Waste Trans fers 0 Annual Certification
0 Rainfall 0 Stocking 0 Crop Yi e ld 0 120 Minute Inspe ctions 0 Monthly and I" Rain Inspectio ns 0 Weather Code
22 . Did the facility fail to install and maintain a rain gauge? DYes [1 No D NA ONE
23 . If selected , did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes 00 No D NA O NE
24. Did the facility fail to calibrate waste application equipment as require d by the permit? DYes 5:1No DNA ONE
25. Did the facility fail to conduct a s ludge survey as required by the permit? DYes Iii No DNA O NE
26. Did the facility fail to have an actively certified operator in charge? DYes KlJNo DNA ONE
27 . Did the facility fail to secure a phosphoru s loss a ssessment (PLAT) certification? D Yes 0No DNA ri)NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes
and report the mortali ty rates that were higher than normal?
lj]No DNA ONE
30. At the time of the in spection 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 O NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/i nspection with a n on-site representative? DYes (}I No D NA ONE
33. Does facility require a follow-up visit by same agency? DYes ~No DNA O NE
11/18104
General Information:
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
Date: fA/1'/?~
Time: 11;oo
FannName: B~B \jnJJ9. \ ··(
Owner Name: pil\ j t B.~ l'i r::i:J6:
County: . · S.4.siM
Phone No:C<=r1o) '56<f -vf7o
On Site Representative: lb\lUv\ Lli '~1:0V\
Mailing Address : C,~ 3/ ttJ 5 4;).1 N
Integrator: _ ___._£_!"f.;:..;s;_~=-'-i!P""-------
Gll"±on 1 NC. ~832-8
~----------~L=a=tiru==d~e:====='~==~'====~L=o=n~~~·ru=d~e~=====~'====~'====~--------~1 -
Operation Description: (based on design characteristics)
Type of Swine No. of Animals
OSow
a Nursery
~eeder _t;/4S:
Other Type of Livestock:
Type of Poultry No. of Animals
Q Layer
0 Non-Layer
Number of Animals:
Type of Cattle
a Dairy
OBeef
No. of Animals
Ntlmber of Lagoons: J. (include in the Drawings and Observations the freeboard of each lagoon)
F~cilitv Inspection:
Lagoon . .
Is lagoon(s) freeboard less than 1 foot+ 25 year 24 hour_ st~rm storage?:
_Is seepage observed from the_ lagoon?:
Is erosion observed?:
-Is any discharge observed?
0 Man-made 0 Not Man-made
Cover Crop
Does the facility need more acreage for spraying?:
Does the cover ~rop need improvement?:
( list tht! crops which need improvement)
Crop type: CoG.st-J,, Acreage:. ______________ _
Setback Criteria . . --, ·.
Is a dwelling located withiri 200 feet of waste application?
Is a well located within 100 feet of waSte application? ·-· .: · ....
Is animal waste~tockpiled within 100 f~t of USGS Blue Line S~eam?
. -
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream?
AOI-January 17,1996
YesO No>(-
YesO No~
YesO No~f
YesO NoZl
..... ~
YesO No~
YesO No~
·.Yes· a ··;~<?~.·
Yes· o ;: .. No~ .. :.. ~-::.-.
YesO . No§J
'••• O'W '• ' -· ' -·-··
YesO No~
Maintenance
Does lhe facility maintenance need improvemenl?
Is there evidence of past discharge from any part of the operation?
Does record keeping need improvement?
YesO NoKl
YesO No !Sa
YesO No~
Did the facility fail to have a copy of the Animal Waste Management Plan on site? YesO NoJa
Explain any Yes answers:. ____________________________ _
cc: Facility A.rsessment Unit
Drawin2s or Observations:
--~· _; :.. ... ! !
AOI-J anuary 17,1996
. .
Use Attachments if Needed
.. ·
... . .
. :•~:·~···.,.;;,,_:·.~ ._;·:~·r •.t ··~ ·~:~:~ ~~l·! .i ~~;:~"'!f·b:r:.:~:l·~~-~~·l'a\,1.' ~ ":1 "--· .. ·
.. ::.·
Type of Visit e Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit e Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access
I nate of Visit: IS /).f/l?Y! Time: I I : or-
Facility Number I :¥t51 H ~/s-"----------------------...,; IO Not Operational 0 Below Threshold
m Permitted Date Last Operated or Above Threshold:
Farm Name:
12] Certified C Conditionally Certified [J Registered
/:,ada 1/ ; -So..u.> J:;;; ,_ m
/
County: _ _,.5=-=a=-""":...:!...f"f:.=*~o::..;"-.::.....----___,_f=_R....:..a __
Owner Name: Jo...~:o;..,. ~ f?:,',\11 1'1"'-..Q-.\1 Phone No: ~ ID -r'jL
Mailing Address: 3s3 C<-d2a ..... L-al.cs. L..o-..c. NC
Facility Contact: ---------------Title: ------------PhoneNo: -----------
Integrator: f .-e: s+s1 <-~a. ..... ..-:> Onsite Representath·e: -;:I c.. do r I '1 ~.oil a.\\
Operator Certification Number: ~ I 9 / a2 3 Certified Operator: "J"" <1. .s o fJ _(.:...'1-i--=-...,~~= .. ;::....:..\\.l..-____ _
Location of Farm:
[lt Swine 0 Poultry 0 Cattle D Horse Latitude
Discharges .& Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated a t: D Lagoon D Spray Field D Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system ? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impac ts or potential adverse impacts to the Waters of the State other than from a di scharge?
Waste Collection & Treatment
4. Is storage capaci ty (freeboard plus s torm storage) less than adequate?
Identifier:
Freeboard (inc hes):
05103101
Srrucrure I
I
S tructure 2 Structure 3
0 Spillway
Structure 4 Strucrure5
DYes DNo
DYes DNo
DYes DNo
NIA
DYes DNo
DYes DNo
DYes DNo
DYes DNo
Suucture 6
Continued
Date of Inspection IS I /J' )O"f I
Required Records & Documenlor;
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?
(ie/ WUP, checklists, design, maps. etc.)
23. Does record keeping need improvement? If yes , check the appropriate box below.
D Waste Application 0 Freeboard D Waste Analys is 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?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection 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 Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain 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 0 Crop Yield Form D Rainfall 0 Inspection After 1" Rain
0 120 Minute Inspections 0 Annual Certification Form
DYes (JNo
DYes fi1 No
DYes flJNo
DYes IiJ No
DYes liJNo
DYes ~No
DYes E}No
DYes (!}No
DYes [XJNo
~Yes 0No
DYes 00No
DYes ~No
DYes !&)No
DYes f:QNo
DYes _KiNo
11;1 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
..... -
-....
12112/03
Date of Inspection I S /1 i J P¥ I
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ 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 environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
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 maintenance/improvement?
11, ls there evidence of over application? If yes, check the appropriate box below.
D Excessive Ponding D PAN D Hydraulic Overload D Frozen Ground 0 Copper and/or Zinc
12. Crop type oa-t J)
13. Do the receiving crops differ with those de ignated 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 detennination?
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 agitation?
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 structure, and/or public property)
20. 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.
CoM 'f' c.-"'..\-\ 0"'-
f> l!>'f:) ,J . l-\ c. ~-' \\
DYes ~No
DYes ~No
DYes J(J No
DYes I]! No
DYes t(J No
DYes ~No
DYes [ijNo
DYes ~No
DYes f:lNo
DYes [).No
DYes BNo
[iJ Yes 0No
DYes 1;21 No
DYes []I No
DYes I:ZJ-,No
DYes !;!No
DYes ~No
Reviewer/Inspector Name ~:~~~~;y~~~~~~~tl[~j~~~J~}~j£~,;~i[~~~i~w-,[~~1~~~~~~~FZ~:~'
Reviewerllnspector Signature: Date: S//.? / 0 ~
12112103 Continued