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HomeMy WebLinkAbout820620_INSPECTIONS_20171231NORTH CAROLINA Deparbnent of Environmental Quality Owner Name: Mailing Address: Physical Address: Facility Contact: Onsite Representative: Certified Operator: ( ( Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: D Structure D Application Field a. Was the conveyance man-made? Phone: D Other: b. Did the discharge reach waters of the State? (If yes, notify DWR) c. What is the estimated volume that reached waters ofthe State (gallons)? 0 Denied Access Region:,m_ Phone: lnteg<atoro f'.tcf~~ Certification Number: "'~:.;;;....l.)~~.......;;.--=r _____ _ Certification Number: Longitude: D Yes G}Ntr 0 NA ONE DYes 0 No EfNA ONE DYes 0 N o EJNA O N E d. Docs the discharge bypass the waste management system? (If yes, notify DWR ) 0 Yes 0No (3"NA 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 ofJ DYes DYes []1io D NA O N E rJN o DNA O N E 21412015 Continued I FaciKty Number: IDate of Inspection: /<2ftG'1 IJ r ' Waste Collection & Treatment lis storage capacity (structural plus storm storage plus heavy rainfall) Jess than adequate? a. If yes , is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the inte1,'Tity 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 I2J1ifA 0 NE Structure 5 Structure 6 DYes~ DNA ONE DYes~ DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR ~o any of the structures need maintenance or improvement? ~ @Jo 0 NA 0 NE 8. Do any ofthe stru~:tures la~:k adequate markers as required by the pennit? DYes ~o 0 NA 0 NE (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes~ DNA ONE D Yes Q-MO D NA 0 NE I I. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~ D NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> IO%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): ,'3ev.M...:.uln.._SG 0 ·(Z(c /1"<::' f 13. Soil Type(s): I 4. Do the receiving crops differ from those designated in theCA WM P? 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 wenable acres determination? I 7. Does the facility lack adequate acreage for land application? I8. Is there a lack ofproperly 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 0Design 0 Maps 0 Lease Agreements DYes EtNo DNA ONE DYes ~DNA ONE DYes ~ DNA ONE DYes ~0 DNA ONE DYes tfNo DNA ONE DYes ~ DNA ONE DYes ITNo DNA ONE Oother: 21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes ~ D NA 0 NE 0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Tr~sfers 0 Weather Code 0 Rainfall D Stocking 0 Crop Yield D I 20 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey 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? Page 2 o/3 DYes~ DNA ONE D Yes CJ No 0 NA 0 NE 214/2015 Continued !Facility Number: S?: -(; ~C) I nate of Inspection: / 1---::Jrc.. \ IS 24: Did the facil ity tail 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 19--NcJ DNA D 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 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 ofthe 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 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? DYes 8-NO DNA ONE DYes ~ DNA ONE DYes ~ DNA ONE DYes ~ DNA ONE DYes ~ DNA ONE DYes ~0 DNA ONE DYes [Z(No DNA ONE DYes gt: DNA ONE DYes DNA ONE c~.~~~ts~rerer,to q~est,!~n ~f,.E~.Iai~;'~"})t•X~~,f,{t.ns~.ers .. ,~~dl~.r,1any~add,!P,on~~J ~~~~da<~~ns,~~-any.other-conipleil~. Use" drawings ofracility to _better exjJiain situations (use additiooalpages as necessary). · Co -v~ Reviewer/Inspector Name: Reviewer/Inspector Signature: Page3 of3 o-'f. r Phone:C( 1 1 0 -L{t\-3 3 3 L{ Date: I d., ~ '=? t1 l/412015 ompliance Inspection Operation Review Structure Evaluation Reason for Visit: ~utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Denied Access Date of Visit: Arrival Time: I()J :1) ;4 I Departure Time: I'JJ JO (11 County: Region~ Farm Name : 71Jefluc..J &7 'fii~ Owner Email: Owner Name: ~ (~ )#~._( Phone: Mailing Address: Physical Address : Facility Contact: Phone : Onsite Representative: I( Integrator: Certified Operator: r Certification Nu mber: ;:2.. ~J. 5 ~ Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts 1. Is any di scha rge observed from a ny part of th e operation? Di scharge originated at: D Struc ture D Application Field a . Was the conveyance man-mad e? 0 Other: b . Did th e discharge reach waters of the State? (If yes, notifY DWR) c. What is th e estimated vo lume that reached waters of the State (gal lons)? Certification Number: Longitude: D Yes~ D Yes 0 No D Yes 0No d . Does t he discharge bypass the waste management system? (If yes, noti fY DWR) 0 Yes 0No 2. I s the re evidence of a past discharge from any part of th e operation? 3. Were there any observable adv erse impa cts or potential adverse impacts t o the waters of the State other than from a di sc harge? Page I of3 D Yes G}No D Yes e::fNo D NA O NE ~A O NE g..N7\ O NE ~A O NE D NA O NE DNA O NE 21412015 Continued [!acili~ Number: I Date of Inspection: 7\fy=t:.-f.( /6 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 I Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): ~'f 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 c losure plan? DYes ~DNA ONE 0 Yes 0 No [3-NA 0 NE Structure 5 Structure 6 0 Yes g'1((o 0 NA 0 NE DYes g..Mb DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9 . Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0 . Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes~ DYes ~o DNA ONE DNA ONE DYes ~o DNA ONE DYes ~o DNA ONE II . Is there evidence of incorrect land application? Ifyes, check the appropriate box below. 0 Yes B""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 0 Application Outside of Approved Area 12. C rop Type(s): ~~ Jt.tf{ Par~ '>~6 U 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 si te need improve ment? 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? I 8 . Js there a lack of properly operating waste appli cation equipment? Required Records & Documents 19 . Did the facility fail to have the Certificate of Coverage & Permit readil y available? 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check the appropriate box. OwuP Ochecklists 0 Design 0 Maps 0 Lease Agreem ents 2 I. Does record keeping need improvement? Jfyes, c heck the appropriate box below. 0 Yes ~0 D NA ONE 0 Yes ~ DNA ONE 0 Yes ~0 DNA O NE 0 Yes g.No DNA ONE 0 Yes B'No DNA ONE DYes ~0 DNA ONE DYes IZf'No DNA ONE DOther: DYes IZ(No DNA O NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Ana ly sis 0 Waste Transfers 0 Weather Code 0 Rainfa ll 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Insp ections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? D Yes tJ No 0 NA 0 NE 23. If selected , did the fa cility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes d No 0 NA 0 NE Page 2 of3 21412015 Continued !Facility Number: 8X.: -{j)IO loate of Inspection: J3 5 :j;lJ In • I 24 . Qid the facility fail to calibrate waste application equipment as required by the permit? DYes 2s:1s the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. DYes DNA ONE DNA ONE 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 facili ty pose an odor or air quality concern? If yes , contact a regional Air Quality representative immediately . 30 . Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge , freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Application Field 0 Lagoon/Storage Pond D Other: 32 . Were any additional problems noted which cause non-compliance of the permit orCA WMP? 33 . Did the Reviewer/I nspector fail to discuss revi ew/i nspection with an on-si te representati ve? 34. Does the facility require a follow-up visit by the same agency? DYes ~ DNA DYes ~ DNA DYes Q¥o DNA DYes ~ DNA DYes EfNo DNA DYes ~ DNA DYes ~No DNA DYes dNo DNA DYes dNo DNA Comments (refer to question tf): Explain any YES answers and/or any additional recommendations or any other comments. Use drawings of facility to better explain situations (use additional pa es as oecessary). ~l ~t f"Vf'~ .S{"-4~~~ -3DB -b~S ( ONE ONE ONE ONE ONE ONE ONE ONE ONE Reviewer/Inspector Name : Reviewer/Inspector Signature: Phone: i{;j J~ 3 3 ,j Date: /3~ /1 Page 3 of3 21411015 Type of Visit: Comyliance Inspection Operation Review Structure Evaluation 0 Technical Assistance Reason for Visit: ~outine 0 Complaint 0 FoUow-up 0 Referral 0 Emergeoc 0 Other 0 Denied Access Date of Visit: llf @tit I Arrival Time: I /l~ 1(/! I Departure Timed /13o;A County: S" rtf Region: ff?& Th .t>~ &y mc.pftp(.,f OwnerEmail: Farm Name: ( Owner Name: ' tl Phone: Mailing Address: Physical Address: ----------------~----~-------------------------------------------------------------- _ _.I_~--~--...;;~--~L...-;,..__---Jf~ __ Title: ---------Phone: Facility Contact: Onsite Representative: Certified Operator: tl 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: 0 Structure 0 Application Field a. Was the conveyance man-made? D Other: b . Did the discharge reach waters of the State? (If yes, notify DWR) c. What is the estimated vo lume that reached waters of the State (ga llons)? Integrator: Pro b~ Certification Number: "5 'J..SJ Certification Number: Longitude: DYes ~NA DYes 0No ~ DYes 0No ~ ONE ONE O NE d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No @?~ O NE 2. Is there evidence of a past dis charge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impac ts to the waters of the State other than from a discharge? Pagel of3 DYes ~0 DYes @<o D NA O NE DNA O NE 114/2014 Continued lFacility Number: I nate of Inspection: 4 f'5k /Q I J Wast~ .. 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 Structure3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Aie there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, s evere erosion, seepage, etc .) 6. Aie there s tructures on-site w hich are not properly addressed and/or managed through a waste m a nagement or closure plan? DYes ~DNA O N E 0 Yes 0 No EJ'NA 0 NE Structure 5 Structure 6 0 Ye s [B-'NO D 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 s tructures need maintenance or improvement? 8. Do any of the s tructures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any pan of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~DNA ONE DYes~ DNA ONE DYes ~ DNA ONE DYes ONE I I . Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~D NA ~QNA ONE 0 Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Inc orporate M anure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12 . Crop Type(s): Bt""'~ 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 fac ility fail to secure and/or operate per the irrigation design or wettable acres d etermination? 17 . Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application eq uipment? Required Records & Documents 19. Did the facility fail to have the Cenificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of th eCA WMP readily avail able? If yes, check the appropriate box. 0 Yes ~DNA D Yes ~DNA DYes ~NA DYes ~NA DYes D NA DYes ~0NA DYes ~DNA O NE O NE ONE ONE ONE ONE O NE D Maps 0 Lease Agreements OOther: __ ___,..-------- 2 I . Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~o D NA 0 NE OwuP Dchecklists 0Design 0 Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Ana lysis 0 Waste Trans fers D Weather Code 0 Rainfall 0 Stocking 0 Cro p Yield 0 120 Minute Ins pections D Monthly and I " Rainfall Inspections JJ Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~ D NA 0 NE 23.1fselected, did the facili ty fail to install and maintain rainbreakers on irrigation equipment? DYes ~ 0 NA 0 NE Page2of3 11412014 Continued l&cility Number: I Date of Inspection: q§ /6 I 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25 . Is the facility out of complia nce with permit conditions related to sludge? lfyes, check the appropriate box(es) below. DYes DYes 0 Failure to complete annual sludge survey 0Failure to develop a POA for s ludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fai l to provide documentation of an actively certified operator in charge? 27. Did the facility fail 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 facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to noti fy the Regional Office of emergency situations as required by the permit? (i .e., discharge, freeboa rd problems, over-application) 3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate b ox below. DYes DYes DYes DYes D Yes DYes 0 Application Field D Lagoon/Storage Pond 0 Other: ------------------------ 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? D Yes 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes 34. Docs the facility require a follow-up visit by the same agency? DYes ~_D NA ONE crNo DNA ONE ~ D NA O NE ErN: DNA ONE &a DNA ONE ~ DNA ONE ~ D NA O NE ~ DNA O NE ~0 DNA ONE 01o DNA ONE ~0 DNA ONE Comments (refer to question If): Explain any YES answers and/or any additional recommendations or any otber comments. Use drawings of facility to better explain situations (use additional pages as necessary). · ( J--3 D-{ S . (~-z_-! t-0 ~~ 0 so% Reviewer/Inspector Name: Reviewer/Inspector Signature: Page3of3 Phone: tt33-33 f r Date: t{ F-dJ / b 21411014 Denied Access I'Ff &1 t) Arrival Time: I f/'...!lo I Departure Time:l/7\~ ro Farm Name:;,____J1-oJ........:.-=-~.......::..:.:::.5,__....;f2,:__---+~\11=-~t-=-.;;........:L....-...J.Jf}u.::....:....._""_f""f--l-Owner Email: I County: . ·}If JtfJ Region: r:I_2::<) Date of Visit: Owner Name: l( Phone: Mailing Address: Physical Address: ----------------------------------------- Facility Contact: --~~---------Title: ~~ Phone: Onsite Representative: 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: 0 Structure 0 Application Field a. Was the conveyance man-made ? 0 Other: b. Did the discharge reach waters of the State? (If yes, notify DWR) c. What is the estimated volume that reached waters of the State (gallons)? Integrator: --~P'------------ Certi.fication Number: ..ll..f}.j--'S=-J-5 __ F ____ _ Certification Number: Longitude: DYes ~NA ONE DYes 0No ~ONE DYes 0No 0-NA ONE d . Does the discharge bypass th e waste management system? (If yes, notify DWR) 0 Yes 0No []1Ci: ONE 2 . Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adve rse impacts to the waters of the State other than from a discharge? Page 1 of3 DYes D Yes [3'No DNA ONE ~ DNA ONE 21412014 Continued loate of Inspection: 2l11ty '/~ I I Facili2' Number: 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 Identifi er: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 'J.-1 5. Are there any immediate threats to the integrity of any of the structures ob se rved? (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 0No ~ONE Structure 5 Structure 6 0 Yes [L;}HO DNA 0 NE DYe s ~ DNA ONE If any of questions 4-6 were answered yes, and tbe situation poses an immediate public healtb or environmental tbreat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9 . Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10 . Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? 0 Yes (8-M<) DNA D NE DYes ~DNA ONE DYes ~DNA ONE DYes~ DNA ONE II . Is there evi dence of incorrect land application? lf yes, check the appropriate box below. D Yes [41</o DNA D NE D Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) D PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus D 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): pe.v~ sc,D 13 . Soil Type(s): 14 . Do the receiving crops differ from those designated in theCA WMP? 15. Does the receiving c rop 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? I 7. Does the facility Jack 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. 0 WUP 0Checklists 0 Design 0 Maps 0 Lease Agreements 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes DNo D NA ONE 0 Yes D No D NA ONE 0 Yes 0No DNA ONE 0 Yes 0No DNA ONE 0 Yes 0No DNA O NE DYes 0No DNA ONE 0 Yes DNo DNA ONE Oother: 0 Yes DNo D NA D NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers D Weather Code 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspection s 0 Monthly and 1" Rai n fa ll Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes 0 No D NA 0 NE 23 . If selected, did the faci lity fail to install and maintain rainbreakers on irrigation equipment? Page 2 ofJ 0 Yes D No D NA 0 NE 21412014 Continued (~acility_..Number: ~ J; -b'@=o I I Date of Inspection: 2:J th.tj 24. Did the facil ity 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. I DYes ~DNA ONE D Yes ~DNA O NE 0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structurc(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? / DYes ~0 DNA ONE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes ([}NO DNA ONE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes ~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? D Yes ~ DNA ONE If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency si tuations as required by the DYes ~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 ~ DNA ONE 0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------~ 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes DNA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? DYes DNA ONE DYes ~0 DNA ONE Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. Use drawings of facility to better explain situations (use adc:f~tional ages as necessary). c~cb ~~~ {;{U-J )t &., Reviewer/Inspector Name: Reviewer/Inspector Signature: Page3of3 tl-t l_ -t-.3 ..__ ~33-33Y Date: J. \ ~~ S --~lf.~~~~~O~J4~r~------ Phone: ~mpliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: e'lfOutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: {7kJLoC-'t. flt1 Arrival Time:~ f (j FarmName: k(LP~ 'G=~J Owner Name: ~ 1/JC-~{ I Mailing Address: Departure Time:! r~ 00 I Coun~,.,~ Region~ Owner Email: Phone: Physical Address: --------------.-------------------------------_J].Io.....-..!:(a::::......:....~---'f::..........L../K~f&t~---"1-Title: ------Facility Contact: Phone: { Onsite Representative: 0 ~ Integrator: / ~ '-' Certification N~mber: s-J.-5 <?" Certified Operator: Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? 0 Yes ~NA ONE 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) DYes 0No c§ir.( 0 NE DYes 0No ~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 DWQ) 0 Yes 0No ~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 0 Yes 0 Yes ~ DNA ONE DNA ONE 2/412011 Continued ltadlity Number: !Date of Inspection: ;L6 ~t.--t../'6 DYes ~DNA ONE 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? 0 Yes D No £l..NA-0 NE Structure I Structure 2 Structure 3 Structure4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? DYes~ DNA ONE (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a DYes ~DNA ONE waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or enYironmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~ DNA ONE DYes ~DNA ONE DYes ~DNA ONE DYes~ DNA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~ D NA D NE D Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN 0 PAN> lO% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window D Evidence of w;7 Driti D Application Outside of Approved Area 12. Crop Type(s): e. f-.fo....Jv. 'f.{ c t{ '1 ~ G V 13. Sod Typo(<): /.,J:zol'oo-...., 14. Do the receiving crops diffCTfn: those designated in the CA WMP? 15 . Doe s 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 ava ilable? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box . OWUP 0 Checklists D Design D Map s 0 Lease Agree ments 21. Does record keeping ne ed improve ment? If yes, check the appropriate box below. DYes ~DNA D Yes ~ DNA 0 Yes ~ DNA D Yes ~ DNA DYes ~ DNA DYes ~ DNA DYes ~ DNA Oother: DYes ~DNA ONE ONE ONE O NE ONE ONE ONE ONE D Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Anal ysis 0 Was te Transfers D Weather Code D Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections D Monthly and I" Rainfalllnspec tions 0 Sludge Survey 22. Did th e facility fail to install and maintain a ra in gauge? 0 Yes c;;rNo 0 NA 0 NE 23 .lfselected, did th e fa cili ty fail to in stall and maintain rainbrca kers on irrig ation equipment? 0 Yes ~ 0 NA D NE Pagel of3 214/2011 Continued .. I Facility Number: ~-td-o I IDate oflnspection:.,l~f~/( 24. Did the facility fail to calibrate waste application equipment as required by the permit? D Yes ~ D NA 0 NE 25. Is the facility out of compliance with permit conditions related to sludge? Ifyes, check DYes ~ D NA 0 NE the appropriate box(es) below. 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 to provide documentation of an actively certified operator in charge? DYes 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 0 Yes 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? DYes 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 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 0 Application Field D Lagoon/Storage Pond 0 Other: ------------------------ 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes 34. Does the facility require a follow-up visit by the same agency? DYes ~DNA [EtNO DNA ~ DNA ~0 DNA ~0 DNA EfNo DNA ~0 DNA [3-'I'fo DNA ~0 DNA Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. Use drawings offacility to better explain situations (use additional pages as necessary). F-J./ ONE ONE ONE ONE ONE ONE ONE ONE ONE Reviewer/Inspector Name: Phone:~tv-lf33-333f Date: Q bJ ~~ ~ Reviewer/Inspector Signature: Page3 of3 21412011 Date of Visit: 1/~f} /3 I Arrival Tim e:~-=-----' Dep a rture Time: I r! Io I County:.C_;~;.._~P--- Farm Name :-..~.M.....;.._(P_...h..a......;t....._.'{"+/....:....:tU~(J..::.ufk~t~--B......_~;.&,I,,---­ Owner Name: :J\\ b~S · M Ph ti I I Mailing Addre ss: Owner Email: Phone: Regionrct> Physical Address:----------------------------------------------------------------------------------- Facility Contact : Th ~ r?c, M c.~itle : -----------Pbone: OosUe Represenlat;ve' {( lotegrato" 'ftte:t;; Certified Operato r : L{ Certification Number : 2.5-.:2_· --:;5"_f ___ _ Back-up Opera tor: Location o f Fa rm: L atitude: Disc harges and Stream Imp acts I . Is any discharge observed from any part of the op erat ion? D ischarge ori gi n ated at: 0 Stru cture 0 Appli cation F ield a. Was the conveyance man-made? 0 Other: b . Did the d ischarge reach wa te rs o f the Sta te? (If yes , notify DWQ) c . What is th e estimated volume that reach ed waters of the State (ga ll ons)? C ertification Number: Longitude: D Yes ~ D Yes D No DYes 0 No d. Does the di sc harge by pass th e waste management system? (If yes, no tify DWQ) D Yes 0 No 2 . Is there evidence of a past discharge fro m any part o f th e operation? D Yes @1'Qo 3 . Were there any observabl e adve rse impa cts or potential adverse im pac ts to the waters D Yes ~0 of th e State other than from a discharge? t Pogd of 1 ~~ ~N 4@ \ ;.•..+ ir~l .fi t' DNA ONE 19-NA ONE ~A ONE ~A O NE DNA ONE D NA O NE 21412 0 1 I C ontinued I , !Facility Number: loate 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 1 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? I DYes [LYNo DNA ONE DYes [J.Xo DNA ONE Structure 5 Structure 6 DYes ~o DNA ONE DYes~ QNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~o DYes ~ DNA ONE DNA O N E DYes ~ DNA ONE 0 Yes DNA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes DNA ONE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Accep ble Crop Window 0 Application Outside o f Approved Area e'~"'vJ"-· ~(lllcf-12. Crop Type(s): 13. Soil Typc(s): 14. Do the receiving crops differ fr m those designated in theCA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reguired 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. DYes 0 DNA D Yes ~0 DNA DYes ~ DNA DYes ~0 DNA DYes ~ DNA DYes [{:rNo DNA DYes G{No DNA ONE ONE ONE ONE ONE ONE ONE owup Ochecklists 0 Design D Maps D Lease Agreements 00ther: _________ _ 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~ 0 NA 0 NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code 0Rainfall Ostocking Ocrop Yield D 120 Minute Inspections 0Monthly and 1" Rainfall In spections Osludge Survey 22. Did the facility fail to install and maintain a rain gauge? DYes ~ 0 NA 0 NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~o 0 NA 0 NE Page 1 of3 11411011 Continued · . .. · I I . IFacm!): Numb"' ~J; -~ I loateofl••2"'; •• ,f!; (S'iiift5 I II 24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes QJ.)Io 0 NA 0 NE 25.Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes ~ 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 to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Otber Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Application Field 0 Lagoon/Storage Pond D Other: DYes DYes DYes 0 Yes DYes DYes ------------------------- 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes 34. Does the facility require a follow-up visit by the same agency? DYes [ll>ro QNA ~0 DNA wo DNA ~ DNA ~ DNA ~0 DNA ~0 DNA ~ DNA ~ DNA Comments (refer to que stion#): Explain any YES answers and/or any additional recommendations or any otber comments. Use drawings offacllity to better explain situations (use additional pages as necessary). -- ONE ONE ONE ONE ONE ONE ONE ONE ONE Re viewer/In sp ector Name : Reviewer/Inspector Signature: Pho n{t{D-q 6 3~q Da te :/3f'J ( ~3 Page3 of 3 2141201 1 Inspection @'Routine 0 0 Denied Access Date of Visit: I te\ \\\ 1'). I Arrival Time: I <> 1 ! :!JJ frt'\ I Departure Time: IQ C\~&>~1 County: SAtnpSol'l. Region: f'll.l FarmName: ·N\ cphA:I.L ~u~£~ £eR'tD OwnerEmail: Owner Name: Phone: Mailing Address: Physical Address: ----------------------------------------- Facility Contact: =-:f'bomA > ~:A i \1'\. ~ ~~~\Title: ---------Phone: Onsite Representative: ~horn~ RM 11\C~AJ\ Integrator: £~gs4AS £ Certified Operator: Certification Number: d. 5~58 Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts 1. Is any disch arge observed from any part ofthe opera ti on ? DYes ~No DNA Discharge originated at : D Structure 0 Application Field D Other: a . W as the conveyance man-made? DYes 0 No ~NA b. Did th e discharge reach waters of the State? (If yes , notify DWQ) DYes 0 No 00NA c. What is the estimated vo lume that reach ed waters of the State (gallons)? d. Does the di scharge bypass the waste managem ent system? (If yes , notify DWQ ) D Yes 0No 00 NA 2. Is there ev idence of a past discharge fr om any part of the o peration? 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 D Yes D Yes ~No D NA rXJNo [jNA 2!412f}." O N E O N E 0NF C' r !Facility Number: I Date of Inspection: Ia Z,, /1 "2.... 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 Structure4 Identifier: .J:l ::1 Spillway?: Designed Freeboard (in): l q Observed Freeboard (in): 09 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 0 Yes ~No DNA ONE DNA ONE StructureS Structure 6 0 Yes l}Zl No 0 NA 0 NE 0 Yes &j 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 10. Arc there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~No DNA ONE 0 Yes ~No 0 NA 0 NE DYes ~No DNA ONE 0 Yes (]J No 0 NA D NE 11. I s there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes (E No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc .) 0 PAN D PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Typc(s): ~t,R~u t)A~ OUL'R~E.'i.t> /..:l8· (!\11\Li l lJft R.'i f. 13. Soil Type(s): --J.,i.._.)""-A=....z~"'----------------------------- 14. Do the rece iving crops d iffer from those designated in the CAWMP? 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? 23. If selected, did the faci li ty fail to install and maintain rainbreakers on irri gation equipment? Page 2 of3 DYes ~No 0 Yes lXJ No DYes II] No 0 Yes I]] No 0 Yes IXJ No DYes ltJ No DYes IXJ No Oather : 0 Yes ~No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 0 Yes 00 No 0 NA D NE 2/4120 11 Continued I nate of Inspection: I 9\\\\ \")... !Facility Number: ' \ 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance ~ith permit conditions related to sludge? If yes, check the appropriate box(es) below. 0 Yes [Xi No DYes ~No DNA ONE DNA ONE 0 Failure to complete annual sludge survey D Failure to develop a POA for sludge level s 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fai l 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 immediate ly . 30. Did the facility fai l to notify the Regional Office of emergency situations as required by the permit? (i.e., di sc harge, freeboard problems, over-application) 0 Yes IX] No 0 NA 0 NE 0 Yes [2SI No 0 NA 0 NE 0 Yes I2SJ No 0 NA 0 NE 0 Yes 00 No 0 NA 0 NE 0 Yes lXJ No 0 NA 0 NE 0 Yes ~No 0 NA 0 NE 3 1. Do s ub surface tile drain s exist at the facility? If yes, check the a ppropriate box below. 0 Appl ication Field 0 Lagoon/Storage Pond 0 Other: ------------------------ 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/inspec ti on with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? 0 Yes 00 No 0 NA 0 NE 0 Yes [XI No 0 NA 0 NE 0 Yes lE No 0 NA 0 NE Comments (refer to question#): Explain any YES a~ers and/or any additional recommendations or any otber comments. Use dra~in s of facility to better explain situations (use additional pages as necessary). Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of3 Phone : 910--3o8''lt 85/ Date: u)o/1 ~ 11411011 ··~~~~~~~~~!~!!~-~ ompliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: ~tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: I Z.-?o-1/ I Arrival Time: I@ 7 tJ I Departure Time: I //: fD I County:_,~ Region :~ () Farm Name: tJ't:, 1/faJ { JJu/"3Z"77 ,=:it~ Owner Email: Owner Name: ~~1 8 7 /1(? ,ebe:e/ Phone: Mailing Address: Physical Address: -------------------------------------------~d> Facility Contact: ~-; /JI¢~/ Title: / tff~r'C Phone: Onsite Representative: 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: 0 Strucrure 0 Application Field a . Was the conveyance man-made? 0 Other: b . Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimate d volume that reached waters of the State (gallons)? Integrator: ztrz-~ Certification Number: ~2:,~ Certification Number: Longitude: 0 Yes !B No DNA ONE 0 Yes 0 No D NA ONE DYes 0 No D NA ONE d. Does the discharge bypass the waste ma nagement system? (If yes, notify DWQ) DYes 0 No D NA ONE 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any obse rvab le adverse impacts or potenti al adverse impacts to the waters of the State other than from a discharge? Page 1 of3 D Yes 0 Yes l:8l No D NA ONE !29.No D NA ONE 21412011 Continued "!Facility Number: I Date of Inspection: h--;}0 -1 ( Waste Collection & Treatment • 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. Ifyes, is waste level into the structural freeboard? Structure I Structure2 Structure3 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 [g. No DNA D NE DYes D No DNA 0 NE Structure 5 Structure 6 DYes 3No DNA ONE 0 Yes ~No DNA 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'! ~Yes ~ D NA 0 NE 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 ofthe waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes j8No DNA ONE D Yes 8}, No D NA 0 NE DYes g}No DNA ONE II . Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~ No D NA 0 NE 0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN > IO%or 10 lbs. /0 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): 75rr;uj{)Jt /tJt!d3e d / ...:5zf bJA 13. Soil Type(s): 14. Do the receiving crops differ from those designated in theCA WMP? 15 . Does the receiving crop and/or land application site need improvement? 16 . Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 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 com ponents of theCA WMP readily available? If yes , check the appropriate box. OWUP 0Checklists D Design D Maps 0 Lease Agreements 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes QgNo DNA DYes [5?J.No DNA DYes gNo DNA DYes ~No DNA DYes ~No DNA 0 Yes [g).. No DNA DYes ~.No DNA 00ther: DYes ~No DNA ONE ONE ONE ONE ONE ONE ONE ONE 0 Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers D Weather Code 0 Rainfall D Stocking 0 Crop Yield 0 120 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 ~No D NA D NE 23. If selec ted, did th e fa c ility fai l to ins tall and ma intain rainbreakers on irrigation equipment? 0 Ye s fg} No DNA D NE Pagel of3 21411011 Continued ·IFacilityNumber: @' -b2o I Date of Inspection: k--3!?-1/ 24 . Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. D Yes ~No DNA ONE DYes ~No DNA 0 NE D Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon Li st structure(s) and date offust survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certifi ed operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Otber 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 th e 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 ~No DNA ONE DYes D?J No DNA ONE DYes I2J No DNA ONE DYes [8J No DNA ONE DYes ~No D NA ONE DYes ~No 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? DYes 1&1 No DNA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes L8J No DNA ONE 34. Does the facility require a follow-up visit by the same agency? DYes ugNo DNA ONE Comments (refer to question#): Explain any YES answers and/or any additional recommendatjons or aoy other comments. Use drawings offacllity to better explain situations (use additional pages as necessary). Reviewer/Inspector Name: Reviewer/In sp ector Signature: Page 3 of3 Phone : ~ -PJ-..JJ?o Date : (z -.3o~j 214/2011 Compliance Inspection 0 Operation Review Reason for Visit ~outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: lnz-0'7-rD I Arrh·aJ Time :I I D: 0 D Farm Name: me ?A tl-; I )J v.r~ -c-rY I Departure Time: l If : 0 0 I County:~@==: Region : ff.rrY I 1<7 rn~?ha:l ~I"~ Owner Email: ---------------------------- Owner Name: -rh Dma.~ Phone: Mailing Address: Ph ysical Address: ---------------------------------------------------------------______ _ Fa cility Contact: __....'f.._,....,a.~v-....trl...,_...c___.=n'""1. ....... a.=-··..;...l ____ Title: Ou Jn #!"I I PhoneNo: ________________ ___ Onsite Representative: __ i".,LS.a..c....<~::::::z;. ________________________ _ Integrator: f? r,¥ C ertified Operator: ____ _.,~5:....;~;.....==;;..._----------------------Operator Certification Number: ------------ Back-up Operator: ---------------------------------Back-up C ertification Number: Location of Farm: Latitude: D OD 'D " Longitude: D OD 'D " Discharges & Stream Impacts I . Is a ny discharge o b served from an y part o f th e opera tion? D Y cs lU No D NA D NE Di s ch a rge o ri g inated at: D Stru cture D A pp li ca ti on Fie ld D Other a . Was the convey an ce m an-m ade? DY es DNo DNA ONE b . Di d th e discharge reach wa te rs of the Sta te? (I f ye s , noti fy DWQ ) DYes 0 No D NA O NE c. Wha t is the estimated vo lum e tha t re a ch ed wate rs o f the State (gallon s)? d . Does d isc harge bypa ss th e was te ma nagem e nt syste m? (If y es, noti fY D WQ} D Yes 0 No D NA ONE 2. Is th ere ev idence of a past di sc harge fr om any part of th e operatio n? 3. Were there any adverse impacts or po tenti al adverse im pacts to th e Wa t ers of the S tate other t han from a di scharge? Pa ge 1 o/3 DYes ~No D Yes ~No 12128104 DNA ONE DNA ONE Continued I Facility Number: Q..-",2ol Date of Ins pection IL)-]._9-A 0 Waste Coll ection & Treatment 4. Is storage capacity (structura l plus stonn storage plus heavy rai n fa ll ) less than adequate? a. If yes, is waste level into the structura l freebo ard? Structure I Structure 2 Stru ct ure 3 Structure 4 D Yes ~No D NA O NE D Yes ~o D NA O NE Structure 5 Stru cture 6 Id entifier:------------------------------------------ Spillway'!: Designed Freeboard (in): j CJ Observed Freeboard (in): .3 } 5. Are there any immediate threats to the integrity of any ofthe struc tures observed? (ie/ large trees, seve re erosio n, seepage. etc.) 0 Yes JZLNo 0 NA 0 NE 6 . Are there stru ct ures on-site which are not properly addressed and/o r managed through a waste management or closure plan? D Yes ~No D NA O NE If any of questions 4-6 were answered yes, and the situation poses an immediate public h ealth or environmenta l threat, notify DWQ 7. Do a ny of the structures need maintenance o r improve ment ? 8. Do any of the stuctures la ck adequate markers as requi red by th e permit? (Not applicabl e to roofed pits, d ry stacks and/or wet stacks) 9. Does any part of the waste management sys tem other than the waste structures require maintenance or improvement? Wast e Application 10 . Are there any required buffers, se tbacks, or compliance alt ern a tiv es th at need maintenance/improvement? D Yes ~No D NA ONE D Yes [lt-No 0 NA D NE D Yes ~o DNA O NE D Yes ~o DNA O NE ll. Is there evidence of incorrect ap pli cation? If yes, check the appropriat e box below. DYes ~o 0 NA D NE 0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (C u, Zn , etc .) 0 PAN 0 PAN > 10% or 10 lbs D Total Phosphorus 0 Fai lure to In corporate Manure/Sludge into Bare Soil 0 Outsi de of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Out s ide of Area 14 . Do th e receivin g c rop s differ from those de signate d in th eCA WMP? D Ye s ~0 D NA O NE I 5. Doe s the receiving crop and/or lan d a ppli cati o n sit e need improvement? D Yes ~No DNA O NE I 6. Did the facility fail to secure and/or operate per the irri ga ti on design or we tt able acre determi nation ? D Yes I8,_N o D NA 0 NE I 7. Does the faci lity lack adeq uate acreage for land application? DYes ~No DNA O NE 18. Is there a lac k of properly operating waste appli ca tion equipment? D Yes [d..No DNA O NE Comments (refer to question #): Explain any YES a nswers and/or any recommendat ions or any other comments. Use dra\\ings offacility to b etter explain situations. (use addit io n a l pages as necessary): 5J1-&<.</ t-U~ (.9>:-. 71( ~ ~3~ V"-F"!dB ...... f)~·; 1- 1-..... ,-. . .., -~-----·-·--_, . -----·-· ··~~·-I Phone: <J:tl!.-Y.-33-J-.3 00 Reviewer/) nspecto r Name . "5"1-c~r'-t::... "~ l R eviewer/In specto r S ign at ure: I~ ...J./3?-Date: L;;L -d-c:r-;;l4:> t. D · / 11118104 Contmued I Facility Number: Q -?;ol Date of Inspection IL;.;?f "34> 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. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other DYes ~o DNA ONE DYes laNo DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes I&No D NA 0 NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers D Annual Certification 0 Rainfall D Stocking D Crop Yield 0 120 Minute Inspections D Monthly and 1" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes &No DNA ONE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes gNo DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes (2iNo DNA ONE 25 . Did the facility fail to conduct a sludge survey as required by the permit? DYes ~0 DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes [;i.No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes US) No DNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP ? DYes ~No DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal ? DYes B. No DNA ONE 30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by DYes fii~No DNA ONE General Pe rmit? (ie/ discharge, freeboard problems, over application) 32. Did Revi ewer/Inspector fail to discuss review/inspection with an on-site representative? DYes 62'J No DNA ONE 33 . Does facility require a follow-up visit by same agency? DYes [gl.No DNA ONE 12118/04 Type of Visit e)-Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ~utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access Date of Visit: I ~-~?J Arrival Time: k!£1..._6 I Departure Time: j.J: if£ I Countyf~s-q=:-= Region: PJ?O • Farm Name' )'If-' !.";L ;:s:>-~ ~,.-,.,._ Owner Name: Zi_:_a:'JIJ!CI?Aa ; I OwnerEmail: ---------------------------- Phone: Mailing Address: -------------------------------------------------- Physical Address: _--"7 _____________________________ -------------------------- Facility Contact: ~~...L..J. .... ~"'A1.~o..,~~__,/11:..:......_e~Ph~ ......... C(:::.~c._· .f_ Title: ----------/ Phone No: ___________ _ Onsite Representath·e: __ .._,4::::z...:~:...::.=~-------------Integrator: 7P/~ Certified Operator: _____ .5=-.;;..~-=----------------Operator Certification Number: -------- 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 jgNo D NA ONE Di sc harge originated at: D Structure 0 Application Field 0 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 tha t reach ed waters of the State (gall ons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of th e operation? 3. We re there a ny adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? D Yes 0 No DNA ONE D Yes 0No DNA ONE DYes 0No DNA O NE D Yes ~N o D NA ONE DYes llSJ No D NA ONE 12128104 Continued '• I Facility Number: 8!?--le;Zol Waste Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. If yes. is waste level into the structural freeboard? D Y es 18fNo D NA ONE DYes 0No DNA ONE Structure l Structure 2 Structure 3 Stru ct ur e 4 Stru c t un: 5 Struct u re 6 ldentifi~r: ------------------------------------ Spillway?: ------------------------------------ Desig.ned Freeboard (in): --..... 1'--Cf-1--------------------------------------- Observed Freeboard lin): _ __.if"'-..:.~~--------------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? D Yes ~No D NA ONE DYes [iaNo D NA ONE If any of questions 4-6 were answered yest and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any ofthe structures need maintenance or improvement? aves 0 No 0 NA 0 NE 8. Do any of the stuctures lack adequate markers as required by the pennit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part ofthe waste management system other than the waste structures require maintenance or improvement? Waste Application D Yes l&No DNA ONE 0 Yes f.E_N o DNA 0 NE I 0. Are there any required buffe~. setbacks, or compliance alternatives that need O Yes Q§. No O NA O NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. D Yes ~No 0 NA 0 NE D Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc .) D PAN D PAN> 10%.or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Accep~ble Crop Window 0 Evidence of Wind Drift D Application Outside of Area 12. Croptype(s) ~rrwJa ,/ovrr~J / VU/nkr~ Uu<mou,.r&-,J 13. Soil type(s) _.:::UJ~a.=...u.:::..._ _____________________________ _ 14. Do the receiving crops differ from those designated in theCA WMP? D Yes 0 No DNA ONE 15. Does the receiving crop and/or land application site need improvement? DYes 0 No DNA ONE 16. Did the facility fait to secure and/or operate per the irrigation design or wettable acre detennination'i D Yes 0 No DNA ONE 17. Does the facility lack adequate acreage for land application? DYes 0 No DNA ONE 18. Is there a Jack of properly operating waste application equipment? DYes 0No DNA ONE Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. Use drawings offac::ility to better uplain situations. (use additional pages as necessary): e~VL~ wo,fcrp trtJ ~&¥'Co~"'· ..... f.- ~-==-m u e-1_ 10 /11(', f)'lt-Ph_ a;{ tvi/( ~ i?lDW ~J::. L.,PP+ C.O//J't",-a-5 fl ~v....-J-·r:~'I{V.)J (7:Jl>-v'- f.-... Reviewer/Inspector Name 5"T"C (/ -c: lb~ Phone: 1i 0-t/3:Y J.)oO Reviewer/1 nspector Signature: .~ 7f ..fL._ Date: 7-.d-k'-AJaf1 7 12128/fU Conttnued I Facility Number: f?:?= t,?Q Date of Inspection I )y?t-q9 Ucguirl'd Records & Documenh 19 . Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components ofthe CAWMP readily available? lfyes, check the appropirate box. D WUP D Checklists 0 Design 0 Maps 0 Other DYes ilS-No 0 NA 0 NE DYes !BNo DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes lB. No DNA 0 NE 0 Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification D Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and 1" Rain Inspections D Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~No DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes f&No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAn certification? DYes ~0 DNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes .£§No DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes ®.No DNA ONE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~0 DNA ONE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notifY the regional office of emergency situations as required by DYes ~No DNA ONE General Permit? (iel discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to di~cuss review/inspection with an on-site representative? DYes ~No DNA ONE 33. Does facility require a follow-up yisit by same agency? DYes ~No DNA ONE Additional Comments aodlor Drawing:~: ... 1-- -.... 12128104 I I ' 0 Technical Assistance Reason for Visit 0 Emergency 0 Other D Denied Access DateofVisit: 1£-~:M ArrivalTime:l /'.DO I DepartureTime: Ia?.' If: I County:, ¥,..., Region: tJ5 0 Farm Name: (nc.Th.a;L A}vl<dY p;,~ cr ( Owner Email:-------------- Owne< Nam" Ji, 12!22«. < ;(7 /!1 "'f:_/, 1!.; L Phone: Mailing Address: ------------------------------------------ Physical Address:----------------------------------------- Facility Contact: ---'j(....:....;;.7'~----J./11LJ-_c_,S-J.~...::;...'..:.l ___ Title: ----------P~ No: -------- Integrator: ~,-rn......:....'l'r._~::::...:..:Jr~-=-----------Onsitc Representative: __ 5A"'~z:.~==-------------- Certified Operator: ---~"""an.<~...._ ___ -----------Operator Certification N umber: -------- Back-up Operator: --------------------Back-up Certification Number: Location of Farm: D O II•D" Latitude: L__J Longitude: Discban:es & Stream Impacts I. Js any discharge observed from any part of the operation? DYes ~No DNA ONE Discharge originated at: 0 Structure 0 Application Fie ld 0 Other a. Was the conveyanc e man-m ade? b. Did the discharge reach waters of th e State? (If yes, noti fY DWQ) c. What is the esti mated volume that rea c hed waters of the State (gallon s)? d . Does discharge bypass the waste management system? (If yes, notify DWQ) 2 . Is there evidence of a past discharge rrom any part ofthe operat ion ? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Page I of 3 DYes 0 No DNA ONE DYes 0 No DNA ON E I D Yes 0No DNA ONE DYes ~No DNA ON E DYes il'9-No DNA O NE 1212 8/04 Continued ~ l I Facility Number:&)--wo I Date oflnspection I 5:721d--.or I Waste Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. If yes , is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 D Yes [&iNo DNA ONE DYes IZJNo DNA ONE Structure 5 Structure 6 Identifier:---------------------------------------- Spillway?: Designed Freeboard (in): __ _.../_9-L--------------------------------- ObservedFreeboard(in):_..Jd-"--'9"------------------------------------ 5. Are there any immediate threats to the integrity of any of the structures observed? DYes 181No DNA ONE (ie/ large trees , severe erosion, seepage, etc.) 6. Arc there structures on-site which are not properly addressed and /or managed DYes ~No DNA ONE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threa~ notify DWQ 7. Do any of the structures need maintenance or improvement ? 8 . Do an y 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? ~Yes 0No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes (g!No DNA 0 NE II . Is there evidence of incorrect application ? If yes , check the appropriate box below. 0 Yes mNo DNA 0 NE 0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn , etc.) 0 PAN 0 PAN > 10% or 10 lbs · D Tota l Phosphorus D Failure to In corporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside o f Area 12. Crop ty pe(s) .'&au~ A /c;v-r&r)/ mt!W ffr 13. Soil type(s) W --~~~----------------------------------------------------------------- 14 . Do the receiving crops differ from those designated in theCA WMP ? DYes ~No DNA ONE 15. Does the receiving crop and/or land application s ite need improvement? DYes OO,No DNA ONE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?O Yes &No DNA ONE 17. Does the fa cility lack adequate acreag e for land application? D Yes Ia No DNA ONE 18 . Is th ere a Jack of properly operating waste application equipme nt? D Yes l&_No DNA ONE .. .. ,. -· .. . ... ,Co~ineots .(refer to'-question #):. Explain.any YES,answers ·andlor any recommendations ·or any other comm,ents • . Use drawtDgs offaci_lity to:better explain:situations. (use additional iulgeS as necessary): · · -. ' -~ . .... . . . . . . . ... . . ~ . . . .· ~~1"\..V.~ I))J>r k; '(f """-L c;?'"-$-k ba/'C. of""-' .... r- I r-.... v· .1fi..v~ -~~_ .. , ... . . ,. I Phone: '7fl>-:f_B -J..3 oo Reviewer/Inspector Name l ·~-~ .. Reviewer/Inspector Signature: 572c:J // /-h/r -Date: 5:: c?--2_-d--VD~ Page 2 of 3 ,, 12128104 Contmued ' I t ' I Facility Number: 1:,¢-.. -k;q Required Records & Documents Date of Inspection I £1;7..21--D¥ 19 . Did the facility fail to have Certificate of Coverage & Pennit readily avai lable? 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 0 Other DYes (2{No DNA 0 NE DYes ~No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes 1:81 No DNA 0 NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE 23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No DNA ONE 24. Did the faci lity fail to calibrate waste application equipment as required by the permit? DYes lXI No DNA ONE 25 . Did the facility fail to conduct a sludge survey as required by the permit? DYes ~No DNA ONE 26. Did the faci lity fail to have an actively certified operator in charge? DYes J&1 No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE Other Issues 28 . Were any additional problems noted which cause non-compliance of the permit orCA WMP? D Yes [ig No DNA ONE 29. Did the faci lity fail to properly dispose of dead animals within 24 hours and/or document DYes .ti2] No DNA ONE 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? D Yes j2g No DNA ONE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by DYes ~No DNA ONE General Pennit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE 33 . Does facility require a follow-up visit by same agency? D Yes [3No DNA ONE Additional Comments and/or Drawings: .... r-- -.... 12128104 I Facility Number j ~,;J._ II 9'15ivision of Water Quality s//6 . (', -;;z..;z....,7 H t..;;.o 0 Division of Soil and Water Conservation .....--- 0 Other Agency Type of Visit Cl:etf"mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ~ine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: Region : FRa 1&-~21 me. PhaiL Arrival Time: I 9 .1 DD Departure Time: I j 0'. '()1) I C ounty:, ¥~ Nur:-sery f9-tr~ Owner Email: -------------Farm Name: Owner Name: ti 0 m a 5 Kr -.L./J1.L...!....L!.---'-f1.L.t1 ..... a""""'-; -=L;..__ __ _ Phone: Mailing Address: ----------------------------------------- Physical Address:------------------------------------____ _ Facility Contact: Thoma£ mcT~;L Title: ------------ Onsite Representative: __ ..,.5'-'V'f:n.d-....=:;...!:~------------- Certified Operator: __ .... ....$.c::..o:~:...:....:::-===----------------- Back-up Operator: --------------------Back-up Certificat ion 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 0 Wean to Finish ~Wean to F ecder i.POS"D ~ffSl 10 Layer 0 Non-Layer I I 0 Dairy Co w D Dairy Calf 0 Feeder to Finish 0 Dairy Heife1 0 Farrow to Wean 0 Farrow to F ceder 0 Farrow to Finish 0 Gilts 0 Boars 0Dry Cow 0 Non-Dai ry : 0 Beef St oc ke r i 0 B eef Feed er ; D Beef Brond Cow -· Dry Poultry 0 Lavers 0 Non-Lavers 0 Pullets 0 Turkeys Other D Turkey Poults D Other Number of Structures: [lJ ID Other Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? D Yes ~N o D NA ONE Discharge originated at: 0 Structure 0 Application Field 0 Other a. Was the conveyance man-made'' DYes 0 No D NA O NE b. Did the discharge reach waters of the State? (If yes, notify DW Q) D Yes 0 No D NA ONE c. What is the estimated volume that reached waters of the State (gallon s)? d. Does discharge bypass the waste management system? (If yes . notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? D Ye s 0 No D Ye s ~No D Ye s ~N o 11128104 DNA O NE D NA O NE D NA O NE Continued I Facility Number:~ -faJo j Date of Inspection I (p -,.z.;z-oy 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 I Structure 2 Structure 3 Structure4 0 Yes ~No DNA 0 NE DYes 0No DNA ONE Structure 5 Structure 6 Identifier:----------------------------------------- Spillway?: Designed Freeboard (in): __ IL.....J1t....-__ ------------------------------ Observed Freeboard (in): _....:3~6=----------------------------------- 5. Arc there any immediate threats to the integrity of any ofthe structures observed? 0 Yes [gNo DNA ONE (ie/ large trees , severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or emironmental threat, notify DWQ 7 . Do any of the structures need maintenance or improvement? 8 . Do any of the stuctures Jack adequate markers as required by the pennit? (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 lO . Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? D Yes as!No DNA ONE 0 Yes 18l.No 0 NA 0 NE D Yes {gl No 0 NA 0 NE D Yes [}lNo DNA ONE I 1. Is there evidence of incorrect application? If yes , check the appropriate box below. 0 Yes J;&No 0 NA 0 NE 0 Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn , etc .) D PAN 0 PAN> 10% or 10 lbs 0 Total Phosphoru s 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 t ype(s) Sr=cm w ~"' / () v-er:5aed I .5i.nn.m ,...,..., cJ= J&!J nice An.11~ 13 . Soil type(s) _\,\)LX.."'C&~o.........~~BI-'--------------------------------- 14. Do the receiving crops differ from those designated in the CA WMP? D Yes OiNo DNA ONE 15. Does the receiving crop and/or land application site need improvement? DYes .WNo DNA ONE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre dctcrmination?O Yes ~No DNA ONE I 7. Does the facility lack adequate acreage for land application? DYes ~N o DNA ONE 18 . Is there a lack of properly operating waste application equipment? D Ye s ~N o DNA ONE Comments (refer to question#): Explain any YES answers and/or any recommendations or any other comments. Use drawings offaciUty to better explain situations. (use additional pages as necessary}: • ~ r-... ReYiewer/Jnspector Name S_r ~ ,}-(';, G 1#1TrY Phone: <y;Lo.-q33-::J:J.co .,.. lL~ Date: ~ -;;,;z-.,;?oi> 7 Reviewer/Inspector Signature: ~ 12128104 . Contmued I 1 I Facility Number:~ -t:R2P • Date of Inspection I k4272 ~ b7 Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Penn it readily available? 20. Does the facility fail to have all components of the CA WMP readily available? If yes, ch eck the appropirate box . D WUP 0 Checklists D Design 0 Maps 0 Other 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes 6Q No DNA ONE DYes !}(~No DNA ONE D Ye s 0 No 0 NA 0 NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? D Yes ~No DNA ONE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes IX! No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes (g) No DNA ONE 26 . Did the facility fail to have an actively certified operator in charge? DYes llaNo DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE Other Issues 28 . Were any additional problems noted which cause non-compliance of the permit orCA WMP? D Yes ~No DNA ONE 29 . Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes ~No DNA ONE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE If yes, contact a regional Air Quality representative immediately 31. Did the facility fai l to notify the regional office of emergency situations as required by DYes llCJ No DNA ONE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? D Yes I(] No DNA ONE 33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE Additional Comments and/or Drawings: ..... r- f--... 12128104 ·, Type of Visit ~ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason tor Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access DateofVisit: l&~:oq ArrivaiTime:l.f~DO I DepartureTime: I Z'nfJ I County:------Region: ___ _ Farm Name: 01 e. 'PAa; I JJu r:sr=c,r nf"/1"\; Owner Email: ------------- Phone: Owner Name: Th D"'ka~ 'Ba; /Jta?ha.;L Mailing Address: .. ..,Zu:S..L. ..... IuiL........___,D~o:::...~:u~n.L.hJ-----~.R..;::,..c.;d~.-----_SJc.oac;...,.k___.._,;lf'L .... J....,,....._"L7~"~----...... P........;;;;(!.;..;... _....,t?~!r 3Y s--, Physical Address:------------------------------------____ _ Facilitv Contact: r), D ~ a.b IJ1e.fAOt,'L Title:----------PboneNo: ________ _ Onsite Representative: _./.-::::::..!:~:._=-.;::::~. _____________ _ Integrator: ?("i-$> U~ Certified Operator: .$'~ Operator Certification Number: ,.;2 ,9SY Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts l. Is any discharge observed from any part of the operation? DYes l8{No 0 NA D NE Discharge originated at: D Structure D Application Field 0 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? (lfyes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Page 1 of3 DYes ~No DNA ONE DYes ffJNo DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes _p?lNo DNA ONE 12128104 Continued • l Facility Number: S"J:-G.¢ol Date of Inspection I ? -a:'§l~a Waste CoUection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes ~No DNA ONE DYes ~No DNA ONE Structure 5 Structure 6 Identifier:---------------------------------------- Spillway?: Designed Freeboard (in): __ ,_1_1~-------------------------------- Observed Freeboard (in): _ _,3-o __ -=---------------------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? DYes fig. No DNA ONE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there stru ctures on-site which are not properly addressed and/or managed DYes lXI. No DNA ONE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses ao immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the s tuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management sys tem other than the waste structures require maintenan ce or improvement? Waste Application lO. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? (3Yes 0No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE I I. Is there evide nce of incorrect application? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE 0 Excessive Ponding D 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 Acceptable Crop Window D Evidence of Wind Drill 0 Application Outside of Area 12 . Crop type(s) :i$:row.Ja. tbttQo (twr::r·'n'"'~ G:rt:J-"2-.e. ,/--fanm ac tfrla~<A~-/W/4rrAn-11~ 13. Soil rype(s) --~,L~U"'---'"a~B...__ _____________________________ _ 14 . Do the rec eiving crops differ from those designated in the CA WMP? DYes ~No DNA ONE 15. Does the receiving crop and/or land application site need improvement? DYes ~No DNA ONE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? DYes !At NoD NA D NE 17. Does the facility lack adequate acreage for land applic ation? DYes lltNo DNA ONE 18 . Is there a Jack of properly operating waste application equipment? DYes J)2J No DNA ONE ReYiewerllnspector Signature: Date : Page 2 of3 12128104 I Facility Number: g;;L -L?d Date of Inspection lltz -OJ.r-p~ \ 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 2 L Does record keeping need improvement? If yes, check the appropriate box below _ DYes [8f No DNA D NE DYes ~No DNA ONE DYes ~No DNA ONE D Waste Application D Weekly Freeboard 0 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 1" Rain Inspections D Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes ~N o DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~N o DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes ~No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes J_No 00NA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes !2iNo DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes ~No DNA ONE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~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 (laNa DNA ONE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE 33. Does facility require a follow-up visit by same agency? DYes D!'~No DNA ONE Page3of3 12128104 e Division of Water Quaiity ·· · · ·. 0 Division of Soil arid Water Conservation'· 0 Other Agency . . . Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access / Date of Visit: I~ /3o/#1 Arrival Time: 1/D: 4D J ()eparltue Time: Lj ___ ___Jj County: 5a .... f-Sokl Region: F~o Farm Name: m c e h ,.J..., N v.. y .lC...'L'::s ~ <!2 ............. Owner·Email: -'---------------- Owner Name: __ -'"'"l_,ho_~ ... ~-__.Q~-~ rY\ c e~ u__\, ___ _ Phone: _,(""'5::'--!...1 t)--~~_.s:_~,._7.:........:-----=G~,2,_~~o __ _ Mailing Address: ____$_Sw:_I.__,I,__ _ _._{J..._!J_/Y'_N_ /2....,;Q/J.~-----_5_cJe_~ucb:Ll'""".4.1r~tf---.JI,-LN~C..__ Physical Address: --.LI _,O::_O~il..,_--~.n-L::Os ... fl:..:_.,___~1~--.s.±o.1'_C.. __ -------,.---------____ _ Facilit~· Contact: Title: Phone No: --------- Onsite Representati\'e: _Lh~o...> Yl"\C. eh_~~'-'-----Integrator: ___fr_.:_s-4-a.f ---------- I Certified Operator: I holln£~ @., Operator Certification Number: IJ. .2S..,S8 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 ID Wean to Finish I I I IIXJ Wean to Feeder ll. Dfi:D so so ID Layer 0 Dairv Cow D Dairv Calf D Feeder to Finish 0 Dairy Hcife 1 D Farrow to Wean D Farrow to Feeder D Farrow to Finish D Gilts D Boars 0 Orv Cow 0 No n-Da iry 0 Bee f Stockel 0 Beef Feeder 0 Beef Brood Cow _, Dry Poultry D Lavers D Non-Lavers D Pullets D Turkevs \ Other D Turkev Poults 0 Other Number of Structures: [ZJ. JD Other 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 0 Other a. Was the conveyance man-made? DYes DNo DNA ONE h. Did the discharge rcnch waters ofthe State? (If yes_ notify DWQ) DYes DNo DNA ONE c. What is the estimated volume that reached waters of the State (ga llons)? d. Does discharge bypass the w<:~ste management system? (If yes, notit~· DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? DYes DNo DYes [)ll No 0 Yes ~No 12128104 D NA ONE DNA ONE DNA ONE Continued Date of Inspection I'-/:SO/o.rl ·waste Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. If yes. is waste level into the structural freeboard? D Yes [j No DNA 0 NE DYes rnNo DNA ONE Structure J. Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: ___ '-.:...-/::........ ___ ----------------------------------- Spillway?: 4/ /'-.5/~~----------------------------- Designed Freeboard (in): __ / ··z..J--'J._· ·_ 1 _- 1 · __ --------------------------------- Observed Freeboard (in): --~-=3::;..',..():;..._" __ ------------------------_____ _ 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 [!!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? ~Yes D No DNA D NE 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 {NNo DNA ONE 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? DYes ~No DNA ONE \\'aste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ~No DNA ONE 11. Is there evidence of incorrect application? lfyes, check the appropriate box below. DYes IKJ No DNA D NE D Excessive Ponding D Hydraulic Overload D Frozen Ground 0 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 D Application Outside of Area 14. Do the receiving crops differ from those designated in theCA WMP? DYes [JlNo DNA 15. Does the receiving crop and/or land application site need improvement? DYes [J!No DNA 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination!D Yes ~No DNA 17. Does the facility lack adequate acreage for land application? DYes ~No DNA 18. Is there a lack of properly operating waste application equipment? DYes No DNA ;_CoilliDents (refer:to ~u~tion.#):-~Expbiin.any YES ;w~ers 'aodl~r ;J,J.Y.:reco~~e.i.bti~ns .o.r ~y ot.fle; ~omm~ots" ~U:~ draWingS offaci,Jity to better exptai,o situatioos.:(use a~ditional pages~ ilec~sary)': .· _.: : . ' ·: ':' 0.. ~--. . _ , . ., ... . a -~ .. -· ;t . • • \. ,., , -~ ·•· • __ , ~ r · ~ · · 7-f3e..c..!_ J•~ooAJ c.orn~r b.,.<.. S('o-r """"-~~ \:.c. A~•-..sJcoA.... ~ 0 -C.. lov\, Q. ..._ A <.." • c e ._.c.\ ---<...""*' h C1 "'-~ ~..S h. ~ V <.... \ C... Cl.k~ + l A-+ . . ....... \o c.. ~: y-<-~ ~ --.. --sL \ c.--\-c..\1 • ll., c.o ~ c: ch" J.; + \ o "-~ 0 ...... p .. uJ ~ 0 ~ + ...., 0 hJ > p ~ C:+ i 0 t.).£. • 1:. ..c=' ~\...c. v 0.. .... c.. Q. No+~ e--. 6..C \J io\A4-'o" \A.J'.\l b<... \ ... L"Lt..c:=d... h..~"~ b c..~t'\.. fr1...bt~~ n.-o~ c:: 0 ""' ... c.. c.* <.Oft. I Phone: Re\iewer/lnspector Signature: Date: ONE ONE ONE ONE ONE 12128104 Continued Date oflnspcction I '/lo/N"""I Required Records & Documents 19. Did the fa cility fail to have Certi ficate of Coverage & Permit readily available? 20. Does the facility fail to ha ve a ll components of th eCA WMP readil y available? If yes, check the a ppropirate box . 0 WUP D C heck lists D Des ign D Maps 0 Other 21. D Yes 0No DNA ONE DYes 0No DNA ONE ~ 0No DNA ONE Does record keeping need improvement? If yes, check the appropriate box below. [i;{waste Application ~ekl y Free board D Waste Anal ys is 0 Soil Analysis D Waste Transfers 0 Annual Certification ~ainfa ll D Stocking G1"crop Yield G(i 20 Minute In spections ~onthly and I" Rain Inspections 0 Weather Code 22 . Did the facility fail to install and maintain a rain gauge? DYes 1iJ No DNA ONE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes 0No ~NA ONE 24. Did the faci li ty fai l to calib rate waste application equ ipment as required by the permit? D Yes ~No DNA ONE 25. Did the facility fai l to conduct a sludge survey as required by the permit? DYes 0No ~NA ONE 26. Di d the facility fai l to h ave an activel y certified operator in charge? DYes ~N o DNA ONE 27. Did th e faci li ty fa il to secure a ph osphorus loss a ssessment (PL AT) certifi cation? DYes fiNo DNA liJNE Other Issues 28. We re any addit iona l problems noted which cause non-compl iance of the permit orCA WMP? D Yes ~No DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 ho urs and/or document DYes [JINo DNA ONE an d report the mortality rates that were higher than normal? 30. At the time of the inspection did the fa cility pose an odor or air quality concern? DYes IN No DNA ONE If yes. cont act a regional Air Quality representat ive immediately 31. Did the facility fa il to notify the regional office of emerge nc y situations as required by DYes III No DNA O NE General Perm it? (ie/ di scharge, freeboard problems, over appl ication) 32. Did Reviewer/In spector fa il to di scuss review/inspection with an on-site representati ve? D Yes (J]No DNA O NE 33. Does faci lity require a follow-up vi s it by same agency? DYes Ill No DNA O NE --.. •• •. ·, ' ' ' ~ ' .. .. .. ~ ;) J-A-\l ....._. P"" <.<...~~a...~ \o .-e.<~ c." .... A1 0 ~ e ..... _ r • ... a-L 0 ... , ""~"" \:J c.. c1 o e».--....,.T tL/Y..... ""-' ', "\-~ \ ""-'. -\-.: • \..s. ca.. .t-+ C..\"'o a....... • ... s r ~~ ~ o ..... -o+- L.o-1"\c:..-~<.. f>C."'-'-~ .Jtr<.L ..:"\.-+«--\_. ~o ... J. '-4-~ cJl._ • J.. \ .c ..c '""'"~ o.r r ro v c..~ ~ '""v-. ht!. ~f' lt'c£ 'Ju.ly os'V tnJt. ,. CC-I r~ .J I h c....-+ ft. " c.J ' J.:, .L\.J +o /Y1'. 12118104 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 L __ _:F:_:a~c::il::i".:.· ·.:_"_:· u::m::b:.:e::r~I:8:::~::~H~~:::~::;:2~Q='=::._--j~ Date nf\ ·i~it: llf <>J :a 'f himc: l$i l 0 IO !'ot Operational 0 Below Threshold ~rmitted 9-Certif!. [] Conditionall~: Certified 0 Regi~tered Date Last Operated or Above Threshold: Farm !'arne: l*t~ .. 1= &fha I I Nvc ser-y (;,c/'9 Count~·: .s~ '?'>oa Owner!\ame: TJ,;..."Q(d Bv.y_L..;trl:...:.:c;;...L..P--!~-"'"w..··'-/-----PhoneNo: 1Jo~ ... )&7 ~(,:>40 ~£It Ovn n f< c.l ..5~/e,., hllrj N .-.C_=~'-1.8.= ... ~? B"'""s-=--------__ _ Mailing Address: Facility Contact: 1homrc s I o 7 /VJcPhe .' I Title:---------Phone!\o: ------------ On site Repr-esentath·e : _ _..Tb......,o::.;.,~«~S---'-'t_..a:.;'~' _ _..11 ........ c'-'P.-.~J;,:.' ... ,._.; .... / _____ _ I Certified Operator: ~VLJh""a~muPu.S _ _____.:.I(.oc.~+?-.._/1.......,.,_1'.--"'/,....,aa...:..,;'. /'------- Location of Farm: Integrator: fre.s. -Ia,, e Operator Certification !\umber: ~ine 0 Poultry D Cattle 0 Horse Latitude ...__ _ _.!• LOJ• IL--_---JI.. Longitude I• I Design Current Design Current Design § I· I 1 .. Current Swine Capacitv Population Poultry Capacitv Population Cattle Cal! a em· Pol!ulation I I ~;ean to Feeder ~ouc c,oc~o []Laver 1 I I IODaiEJ: I 0 Feeder to Finish I[ ] Non-Lav er I I I :o Non-Dairv : 0 Farrow to Wean I D Farrow ro Feeder IOOtber I I I 0 Farrow to Finish Total Design Capacity D Gilts I D Boars Total SSLW Number of Lagoons I l I ID Subsurface Drains Present liD Lagoon Area Holdiog Ponds I Solid Traps I I 10 !'io Liguid Waste Management Svstem Discharof5 & Str-eam Impacts 1. Is any discharge observed from any pan of the operation? Discharge originated at: 0 Lagoon 0 Spray Field 0 Other a. If discharg~ is observed, was the con\'eyancc man-made? b. lf discharge is observed . did it reach Water of the State? (lfyes. notify DWQ) c. lf discharge is observed . what is the estimate d flow in ga l/mi n? d . Does d ischarge bypass a lagoon system ? (lfyes, notify DWQ) 2. Is th::re e,·idence of past discharge from any part of the operation? I I D SJ!ra'· Field Area I I ' DYes 8-tro DYes Q1iro DYes GNo DYes ~ DYes G-No 3 . Were there an y adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? DYes G-No \\-'aste Collection &. Treatment 4. Is storage capacity (fr~board plus storm storage) less than adequate? Identifier: Freeboard (inches): 05103/01 Strucrure I Structure 2 Strucrure 3 0 Spillway DYes Q..No Struc rure 4 Strucrure 5 Structure 6 Continued \. I Facility Number: $.;? -t/20 I Date of Inspection 14-.;n-o'i 5. Are there any immediate threats to the integri ty of any of the structures observed? (ie/ trees, seve re erosion , seepage, etc.) 6. Arc there structures on-site which arc not properl y addressed and/or managed through a waste management or closure plan? (If any of questions 4-6 was answered yes, and tbe situation poses an immediate public bealtb or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? 8. Docs any part of the waste management system other than waste structures require maintenance/improvement? 9. Do any stuctures Jack adequate, gauged markers with required maximum and minimum liquid level elevation markings? Waste Apn!ication 10. Arc there any buffers that need maintenance/improvement? II . Is there evidence of over application? 0 Excessiv e Ponding 0 PAN 0 Hydraulic Overload 12. Croptypc fu·cawdal $mal/ .~ra .'n 13 . Do th e receiving crops differ with those designate d in the Certified Animal Waste Management Plan (CA WMP)? 14 . a) Does the facility lack adequate acreage for land application? b) Docs the facility need a wettable acre detel'l11ination ? c) This facility i s pendcd for a wettable acre detel'l11ination ? 15 . Docs the receiving crop need improvement? 16 . Is there a lack of adequate waste application equipment'! Required Records & Documents 17. Fail to have Certificate of Coverage & General Pe l'l11it or other Permit readily available? 18 . Does the facility fail to have all components of the Certified Animal Waste Management Plan re adil y available ? (ie/WU~ecklists;"desigr(map(ete.) /. ~. 7 ~it 1 '7 '].) 19. Does re cord keeping need improve ment? (ie/ irrigati4ccboard, waste/ana(y~soil sample re~ 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 2 1. Did the fac ility fa il to ha ve a actively certified operator in c harge? 22. Fail to notify regional DWQ of emergency situations as required b y General Permit? (ie/ di sc harge, freeboard problems, over application) 23. Did Rcvicwcr/lnspector fai l to discuss review/inspection with on-site representati ve ? 24. Does facility require a follow-up v isit by same agency? 25. Were any additional problems noted which cause noncompliance of the Certified A WMP? DYes DYes DYes DYes DYes DYes DYes DYes DYes D Yes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes jC No violations or deficiencies were noted during tbis ,·isit. You will receh·e no further correspondence about this visit. [J.flro Q.Ko [31q()' ~ Q-NO 8-N"o G}NO ~ 91\fo ~0 [9-lqo .81<lo ~ ~ 9-No 91W G}f(o [9-No ~0 @-No ~ ~0 Comments (refer to question#): E:~plain any YES answers and/or any recommendations or any other comments.. U~e drawings offadlity to better explain situations. (use additional pages ru; necessary): ID Field Copy D Fina l Notes I ·---· ' # /3 t'lr. 1'1c&_1'/ J,~;I(J ~ -f£,Y'*'n'''1 l'lt~,., -far-.sq7bl'•n5 .,.,,.,·f!r., "'I' Yd r /~$1 !>u;.,,..,_., ~)(?oo1~) ~ H~ ~~~s /11 ,e/ v~rt}'q v,J ,IJ :Pt .... el ~~l ~ ,.~.._ \.vvfl Plu, ~,.:/!_,,.,, Hi! .d.,./.,.e/ I p.vl/ ~--./ ~.,,. J(P'I% 1-t~l oi'F A,.J ;S' 'VI>•l:,., +vr It C(N"I't"<t.; l'"t!f"tu·l. TA~u ~N a ~ .... sn, • ../1 ;, ... ks A ;.. rl,~ hoii<Jwo dr .of o,/":,~~ .• ./ ~dll~ fJ,.,.I-·k ,.f, .. s f ,, r :'Y bn~ I.e 1,$ ~,,:.,., 1, 1""-1--le/"56 ;/ f.l;c:v ,&-1 ft,~ ;..,,,,, "'" 6u~5f?~>lr ~~ t?.sfe.6!.s4 ~e.~ <[11"'QH (t>llt>/-~/,.n,.,,,, 1-., I.',_,~ r;,:e l~$ 'riarud.n1 -1<3 ..~ .... / r~por--1., '<.er"nl.> JJ...FL Wd/ 1'<-;,1, -... 05103101 Continued Facility Number:~-C,~o Division of Environmental Management Animal Feedlot Operations Site Visitation Record Latitude: I I Date:~) l.l J 9 ~ r ' Time: I : 'f s= Longitude: Operation Description: (based on design characteristics) Type of Swine No. of Animals OSow ra Nursery (aoSD 0 Feeder Type of Poultry No. of Animals OLayer 0 Non-Layer Other Type of Livestock: Number of Animals: I I Type of Cattle ODairy OBeef No. of Animals Ntimber of Lagoons:_.....!:,__(include in the Drawings and Observations the freeboard of e ach lagoon) ·. Facilitv Inspection: Lagoon _ . - Is lagoon(s) freeboard less than 1 foot+ 25 year 24 ~our storm 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 the crops which need improve~nJ) Crop type: ~d c ±U Acre~e :. _____________ _ · 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 stockpiled within 100 feet of USGS Blue Line Stream? Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream? AOI-January 17,1996 YesO N~ YesO No~ YesO No& YesO No~ YesO No~ YesO No~ YesO -~o~ . -Yes 0 ::.No er Yes 0 No~ Yes 0 No~ .. • •' 0 Maintenance Does the facility maintenance need improvement? Is there evidence of past discharge from any part of the operation? Does record keeping need improvement? Did the facility fail to have a copy of the Animal Waste Management Plan on site? YesO YesO YesO YesO No9' Nola Nofjl No~ Explain any Yes answers:'------------------------------ Signature: ___ :e~Z"--.-L&=---...;;;;....__;::1L----~_-__ Date: c2 /JP/tt, 1 7 cc: Facility Assessment Unit Drawin2s or Observations: AOI-January 17,1996 ,. . . Use Attachments if Needed . . ~---_ ~:. . .. .. . ----·-------- I ·-. '• :-• ...... _ .......