820624_INSPECTIONS_20171231

NORTH CAROLINA
Deparbnent of Environmental Quality
Reason for Visit: 0 Other 0 Denied Access
Date of Visit: lt7~ Htl Arrival Time: I ]lJ i) b Departure Time:! rn rj· I County: f,f-.tfSo(J Region: B2:U
Farm Name: S' n\ cJg, ,";,-S CIA) fSa.-r>41l Owner Email:
Owner Name: Cat' [foV\ 0t'4 t!l-1"--~ i!\e,,c"'r'-Phone:
Mailing Address:
Physical Address:
Facility Contact: Phone:
Onsite Representative: ll Integrator: ....:J'~· :........::c...::.Jt{L...L. _________ _
Certified Operator: c.. D. Certification Number: fll b Olf 0
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
l. Is any di scharge observed from any part of the o peration? DYes ~DNA ONE
Discharge originated at: D Structure D Application field D Other:
a. Was the conveyance man-made? 0 Yes 0No ~A ONE
b. Did the di scharge reach waters of the State? (If yes, notify DWR) 0 Yes 0No (3'NA ONE
c. What is the estimated vo lume that reached waters of the State (gallons)?
d . Does the di scharge bypass th e wa ste management system? (If yes, noti fy DWR) 0 Yes 0No ~A ONE
2. Is there evidence of a past di scharge from any part of the operation?
3. Were there a ny observable adverse impacts or potential adverse impacts to the waters
of the State other than from a di sc harge?
Page 1 of3
0 Yes
0 Yes
ctNo DNA ONE
~ DNA ONE
21411015 Continued
IFacilit)· Number: lnate of Inspection: /7 ~ /8-I
" Waste Collection & Treatment
4}s 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): fJ7
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 ~NA ONE
DYes 0No ~ ONE
Structure 5 Structure 6
DYes ~o DNA ONE
0 Yes ~ 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?
0 Yes c:fNo DNA 0 NE
0 Yes ~o D NA 0 NE
0 Yes E1'No DNA 0 NE
DYes E:(No DNA ONE
ll. Is there evidence of incorrect land app li cati on? Ifyes, check the appropriate box below. 0 Yes ~o 0 NA 0 NE
D 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 O utside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s):
13 . Soi l Type(s): /v, , (z a
I {
14. Do the receiving crops differ from those desi!:,'llated 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 irrigat ion desi!:,'ll or wettable
acres determination?
17. Does the facility lac k adequate acreage for land application?
I 1l. Is there a lac k of properly operating waste app li cation equipment?
Required Records & Documents
19 . Did the facility fail to have the Cc rtitlcate of Coverage & Permit readily available?
20. Does the facility fail to hav e all components of theCA WMP readi ly available? If yes, check
the appropriate box.
0WUP 0 Checklists 0 Dcsit-'11 D Maps 0 Leas e Agreements
0 Yes I::L]..wo DNA
0 Yes ~0 DNA
0 Yes ~ DNA
0 Yes ~0 DNA
0 Yes ~ DNA
0 Yes ~0 DNA
0 Yes [d"No DNA
Oother:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
21. Does record keeping need improvement? If yes, check th e appropriate box below. 0 Yes ~DNA ONE
0 Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysi s 0 Waste T ransfers D Weather Code
0 Rainfall D Stocking D Crop Yield D 120 Minute Inspec tions 0 Monthl y and I" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain ga uge? 0 Yes Ga'No 0 NA 0 NE
23 . If se lecte d, did the facility fail to install and maintain rain breakers on irrigation equipment? 0 Yes [d"No 0 NA 0 NE
Page 2 of3 21412 015 Continued
IFacili?' Number: 9'J -GtV IDate oflnspection: 11 ~ / K
24. Did the faci lity fail to calibrate waste application equipment as required by the permit? 0 Yes ~o D NA 0 NE
2~. Is the facility out of compliance with permit conditions related to s ludge? If yes, check
the appropriate box(es) below.
DYes ~o QNA ONE
0 Failure to complete annual sludge survey 0 Fai lure to develop a POA for s ludge levels
0 Non-compliant sludge levels in any lagoon
Li st structure(s) and date offrrst survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
lfyes, contact a regional Air Quality representative immediately.
30 . Did the faci lity fail to notify the Regional Office of emer gency situations as required by the
permit? (i .e ., discharge, fi-eeboard problems, over-applicat ion)
3 I . Do subsurface tile drains exist at the tacility? If yes, check the a ppropriate box below.
0 Application Field D Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representat ive?
34. D oes the facility require a follow-up visit by the same agency?
0 Yes [!fNo DNA ONE
0 Yes ~0 DNA ONE
0 Yes ~0 DNA O NE
0 Yes ~0 DNA ONE
0 Yes ~0 DNA ONE
0 Yes ~ DNA ONE
0 Yes ~ DNA ONE
0 Yes ~ D NA ONE
0 Yes ~ 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 additional pages as necessary).
C,a_.{tbt.NVftoV\ -~--g_q-Jb
S (.._JJ e-S""""r -'/-JJ -fl
Reviewer/Inspector Name:
Revi ewer/Inspector Signature:
Page 3 of3
Pho ne:UIJ.._ f:J1~J3J'(
Date 17"1 }g
21412 15
Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: O'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: lftS Sf'+[ I Arrival Time: I rc lQ 4 I Departure Time: County: ~m RegionlffC..V
Farm Name: S /'ILJ a...._v-$o"-' ~~ Owner Email:
Owner Name: Cud?: B ~(?Cfl,f Phone:
Mailing Address:
Physical Address:
Facility Contact: · {36-v&J 1~ Title:
Onsite Representative: (( ·
Certified Operator: _.{Jz...........,:..::;· ..:...v-..-_{~t; ____ f3_a; __ r(J,..t,........;::;__.-_+-'-------
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?
D 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:
Certification Number: ff'b tJ I( 0
Certification Number:
Longitude:
D Yes ~DNA O NE
D Yes 0No [3'1JA O NE
DYes 0No Ej'NA ONE
d. Does the discharge bypass the waste management system? (If yes, notifY DWR) 0 Yes 0No aNA ONE
2. Is there evidence of a past discharge from any part of the operation'!
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes @No
DYes 6No
DNA ONE
DNA ONE
21411015 Cominued
[Facility Number: S'Z-b 1-.l{ I I Date of Inspection: 2S A; if 1/B
Wask CoUection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) Jess than adequate?
a. If yes, is waste level into the structural !Teeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 'J-.7
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes~ DNA ONE
DYes D No crN'A D NE
Structure 5 Structure 6
DYes ~o DNA ONE
DYes 0"No DNA D NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or en\ironmental 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
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes
DYes
~0 DNA ONE
ifNo DNA ONE
DYes ~o DNA ONE
D Yes 0No 0 NA D NE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~o DNA D NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D 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 Drift D Application Outside o f Approved Area
12. Crop Type(s): sbo ltr
I 3. 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 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 the CAWMP readily available? If ye s, check
the appropriate box.
Ow uP 0Checklists 0 Design D Maps D Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes ~ DNA ONE
0 Yes ~0 DNA ONE
DYes [2J'No
i
DNA ONE
DYes ~0 DNA ONE
DYes {2f'No DNA ONE
DYes ~No DNA ONE
DYes 0'No DNA ONE
00ther:
DYes Q1(Jo DNA ONE
D Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and l " Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~No DNA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakcrs on irrigation equipment? 0 Yes 0No 0 NA 0 NE
Page2of3 21412015 Continued
!Facility Number: g;tl-4 ,._:'q I (!>ate of Inspection: )...SA-11.1'1({7 I
24. Bid the fucility fail to calibrate waste application equipment as required by the permit? 0 Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes
[!{No
~0
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field D Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
·0 Yes ~No
0Yes ·~o
DYes ~0
DYes @'No
DYes EfNo
0 Yes ~0
DYes ~0
DYes ~0
DYes ~
0NA
0NA
DNA
DNA
DNA
DNA
DNA
DNA
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).
Gt(ytcJl:f\ -~--f cr~ I'
.s [.,_"J(, S~(-t ?j l ,_j ~ o l b
Ce~t
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
PhonefUO-#{33-3JJ l{
Date:~~~,~ /{7
Page3of3 21412015
Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: @'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Owner Name: Phone:
Mailing Address:
Physical Address: -------------------------------------------
Facility Contact: ~5 g~,d'{ Title:
---~~--=~--------------------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: D Structure D Application Field
a. Was the conveyance man-made?
D Other:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Integrator:
Certification Number: j f( Dt{ 0
Certification Number:
Longitude:
0Yes ~ DNA ONE
DYes 0No [31il'A ONE
DYes 0No ~ ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No ~A ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes efNo
D Yes -e::::J No
DNA ONE
DNA ONE
11412011 Continued
IFacility'Number: If~ ,(;J; t{ I nate of Inspection: u ~l6
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~DNA ONE
0 Yes 0 No [!'N/... 0 NE
StructureS Structure6
0 Yes [E"1fo 0 NA 0 NE
0 Yes [3'No 0 NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify 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
lO. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~o
DYes (&"No
0 Yes O'No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
II. Is there evidence of incorrect land application? lfyes, check the appropriate box below. 0 Yes !:A No 0 NA 0 NE
D Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
D PAN D PAN> 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): ~~ Sc,v
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation desi6'11 or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
OwuP Ochecklists 0Desi.b'll D Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes ~0 DNA ONE
DYes (!(No DNA ONE
DYes ~0 DNA ONE
DYes ~No DNA ONE
DYes B"No DNA ONE
DYes ~0 DNA ONE
0 Yes ~0 DNA ONE
Oother:
DYes ~0 DNA ONE
D Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers D Weather Code
D Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and I" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes (2(No 0 NA D NE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
Pagelof3
D Yes [ZfNo 0 NA 0 NE
21412014 Continued
ltoacilityNumber: -6'lf !Date of Inspection: 'i b ~1 f~ I ·
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes l!::f'No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes c:::rN"o
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Application Field 0 Lagoon/Storage Pond 0 Other:
DYes
0 Yes
QYes
QYes
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
~0
cnNo
QA<l'o
(d'No
[2t"No
gNo
[]f'No
@No
~0
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
Comments (refer to question #): 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).
~lb~t-l)flt.-c;,-1o-ft{
sr~~s~-IJ.-1-\ s 0-?_L ~ P-3,7
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of3
Phone: '<33~ 333(
Date : ~d~b~=l--l~~~ _
214/'ZOII
~o,liance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: efRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: IJ lj?f(Js I Arrival Time:t71U o ffl Departure Time:l g'1 /b A I County: J1(Y}1 Region: F{(O
Farm Name: 5"ct'\.d 'h r .s'b (.() Fa..v~ Owner Email:
Owner Name: ~/..6-, CJoc-c.foof Phone:
Mailing Address:
PhysicaiAddress: ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Facility Contact: -----l.::d.-4o'· ,<..:.IIL::....:~.....:'-..._!_13~~.::;....;.;=Gi;::;___Title: -----------Phone:
Onsite Representative: ll
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. rs 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 DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Integrator: .....!...lY\J....L..{)J...L. ________ • ________________________________ _
Certification Number: err ( O((o
Certification Number:
Longitude:
\
DYes ~NA ONE
DYes 0No ~NE
DYes 0No o-m-ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 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
DYes
DYes
~ DNA ONE
~0 DNA ONE
2/412011 Continued
J Facility Number: I nate of Inspection: ~fi.P R l5
·Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which arc not properly addressed and/or managed through a
waste management or closure plan?
DYes (31'fo 0 NA 0 NE
DYes 0No ~ ONE
Structure 5 Structure 6
DYes~ DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
11 . Is there evidence of incorrect land application? If yes, check the appropriate box below.
DYes~ DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DY es ~ DNA ONE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs . 0 Total Phosphorus 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):
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 components of theCA WMP readily available? If yes, check
the appropriate box.
0WUP Ochecklists D Design 0 Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes ~DNA ONE
D Yes ~DNA ONE
DYes gJ..No-D NA ONE
DYes 0.No_0NA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes Q--No DNA ONE
00ther:
DYes CjNo DNA ONE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Wast e Transfers 0 Weather Code
D Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall In spections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23 . If selected, did the facility fai l to in sta ll and maintain rainbreakers on irrigation equipment?
Page 2 of3
DYes
D Yes
~
~
DNA ONE
DNA ONE
2/4120ll Continued
I Facility Number: !Date of Inspection: J APR I~ I
'24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYe s ~ D NA ONE
0 Yes EjN"o DNA 0 NE
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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 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 immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e ., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Yes [J-NO DNA ONE
DYes C}Ntl DNA ONE
DYes c:rNo DNA ONE
DYes Q-NO" DNA ONE
0 Yes ~DNA ONE
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?
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?
C -0~ b ;co·L o 1\
.s (v J J-t~v .ru I
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3of3
0-"' ~
DYes (31ifo D NA ONE
0 Yes [Zt"No DNA ONE
DYes C}rfo DNA ONE
r I 3 /' ,.o
Phone: L{j~~ ~t{
Date: aAPL~ 1 ~
214/2014
Reason for Visit: <51foutine 0 Complaint 0 Follow-up 0 Referral 0 Emer ency 0 Other 0 Denied Access
Date of Visit: ~ . rrival Time: I (f1 ( ¢ J Departure Time:l 7t b {) J CounS_A VVf Regio~
Farm Name: 5 I~C.,{o.._ • l._~W F; v{A. Owner Email:
Owner Name: c~~rk T5av--L{; .. f= Phone:
Mailing Address:
Physical Address : ------:-----------:----------+--------------------
Uv·--+; ~ (?;,p '(CJl't·4itle: rr-J\. Phone: Facility Contact:
Onsite Representative: '( ( -Integrator: ~L-~~---------
Certified Operator: C,-{~ S,~Ach,t-
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge obsetved from a ny part of the operation?
Discharge or igina te d at : 0 Structure 0 Appl icatio n Fie ld
a. Was the con veyance man-made?
0 Other:
b . Did the di sc harge reach waters of the State? (If ye s, not ify DWQ)
c . What is the estim a ted volume that reached waters of the State (gallons)?
Certification Number:
Certification Number:
Longitude:
DYes ~DNA ONE
DYes 0No ~·ONE
0 Ye s 0No ~ONE
d. Does the di sc harge bypass the waste management system? (If yes, notify DWQ) DYes 0No ffi1[A O NE
2. Is there evidence of a pas t di sc harge from any part of the operatio n?
3. Were there any obsetvable adverse impacts or potential adverse impacts to the waters
of the State other than from a disc harge?
Page I of3
DYes
DYes
~ DNA O NE
~ DNA ONE
1/4/1011 Co ntinued
l~acility Number: ~b 6$« I II~ ''{ loateoflnspection:/ Cil< I
I Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. Ifyes, is waste level into the structural freeboard?
Structure I Structure 2 Structure3 Structure 4
Identifi er:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
'""· 32
5. Aie there any immediate threats to the integrity of any of the structures o bserved?
(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 O NE
DYes ~DNA ONE
StructureS 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 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 s tructures r equire
m aintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes~ DNA
DYes~-DNA
DYes ~-DNA ONE
0 Yes Q}MO 0 NA 0 NE
11. Is there evid ence of incorrect land application? If yes, check the appropriate box below. 0 Yes [3-X<(. D NA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen G round 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or I 0 Jb s. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 E v idence of Wind Drift 0 Application Outside of Approved Area
f3 e r ~vJ~ t:-:cc ~ 12 . Crop Typc(s):
13. Soil Type(s): IV o · a ,v-..
14. Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack ofproperly operating waste appli cation equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readi ly available? If yes, check
the appropriate box.
DYes ~:DNA
D Yes aJ..Ntr · D NA
D Yes ~-DNA
DYes g.No DNA
DYes ~-DNA
DYes (]f'No DNA
DYes Q-.Wo-DNA
O NE
ONE
ONE
ONE
ONE
ONE
ONE
0WUP 0Checklists 0 Design D Maps D Lease Agreements 00ther : _________ _
21. Docs record keeping need improvement? If ye s, check the appropriate box below. 0 Yes [LJ-No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analy sis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I " Rainfall Inspections 0 Sludge Survey
22. Did the fac ility fai l to install and maintain a rain gauge? 0 Yes ~o DNA D NE
DYes ~o DNA ONE 2 3 . If selected, did the facility fail to in stall and maintain rain breakers on irrigation equipment?
Page 2 of3 21412011 Continued
IFacmtyNumbe" (k£#{ I !Doteoflnspection/7&• /L/1
14. Did the facility fail to calibrate waste application equipment as required by the pennit? 0 Ye s @-No-0 NA 0 NE
25. Is the facility out of compliance with pennit conditions related to sludge? If yes, check 0 Yes ~ D NA 0 NE
the appropriate box(es) below.
D Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below .
0 Application Field D Lagoon/Storage Pond D Other:
DYes
DYes
DYes
DYes
DYes
0 Yes
------------------------
32. Were any additional problems noted which cause non-compliance of the pennit orCA WMP ? DYes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representati ve? DYes
34. Does the facility require a follow-up visit by the same agency? DYes
~ DNA
~0 DNA
g.-No DNA
~0 DNA
[dfio DNA
~ DNA
~ DNA
{]}No DNA
~ DNA
Comments (refer to question#): Eiplain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better eiplain situations (use additional pages as necessary).
S((}d)'t (tpJ~ II -!1-(j
c ~(l b ~k--v\ { 1-9-1 ~
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of3
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
t·
ompliance Inspection
Reason for Visi t: ®'Routine 0 Complaint 0 Denied Access
Date of Visit: I slol}l~ I Arrival Time:I07WJQI'\ I Departure Time:lo,~us-;a County: c§tll"psoo Region: F/0
Farm Namc: __ ___;;~::s:a.a.Lllt.Cllo....o!..~ ~::....:.:::~~~:::.....:So:.....oQ::..::W=.-....:~....:~.!!tl..:.:~~----Owner Email:
Owner Name: Q_f\ R \ -\-ot0 ~ AR~to_, T Phone:
Mailing Address :
Physical Address : -------------------------------------------
Title: Phone: Facility Contact: C , ) R-t'I-5 :J3 flg w;IC ( -----------
On site Rcpre sentath·e: SA f1\ £ --~~~----------------------Integrator: IN OE.(!Cf\f)E ttJJ
Certified Operator: C,AR 1-lon cf:u.,..c;..{f'+I.~ Certification N umber : S'BtqOL-(0
Back-up Operator: Certification Number:
Location of Farm: Latitude: Lon git ude:
Discharges and Stream Impa cts
I. Is any discharge observed fro m a ny part of the operation ? ffves 0 No DNA O NE
Discharge originated at: 0 Struc ture 0 App lication Fi e ld 0 Other:
a . Was the conveyance man-made?
b. Did the discharge n:a ch waters of the St ate? (If yes. no tify DWQ)
D Yes 0 No (SYNA O NE
0 Ye s 0 No ~A O NE
c. Wh at is the estimated volume that reach ed waters o f th e State (gallons)?
d. Doe s the di sc harge bypass the waste management system? (lf yes, notifY DWQ) 0 Ye s 0 No ~A ONE
2. Is there evidence of a past discharge from any part of th e operation ?
3. We re there any observable adverse impacts or pote ntial ad ve rse impacts to the waters
of the State o ther th an from a discharge?
Page I of3
0 Yes
0 Yes
GJINo DNA ONE
~0 D NA ONE
214120 11 Continued
. '
!Facility Number: ~d. !Date of Inspection: s/0 I I I~
r l
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure4
Identifier: ~~ ..-=
Spillway?:
Designed Freeboard (in): __.IL..Ci....!..._ __
Observed Freeboard (in): ~ f"
5. Arc 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 managem ent or closure plan?
DYes ~No DNA ONE
D Yes 0 No [9'NA 0 NE
Structure 5 Structure6
0 Yes G{No DNA D NE
0 Yes c:{No DNA 0 NE
If any of questions 4-6 were answered yes, and tbe situation poses an immediate public bealtb 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 appli cable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
DYes ~No DNA ONE
DYes [S(No DNA 0 NE
DYes ~o DNA ONE
D Yes ~o DNA ONE
D Yes Gf'No DNA ONE
0 Excess ive 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
0 Outside of Acceptable Crop Window D Ev idence of Wind Drift D Application Outside of Approved Area
12.CropType(s): ~tR.C!=-uO~ (H~;..) f""E.sc.ut.. ( i-\~'f\ ~.G. 0·
13 . Soil Type(s): ~o ~ C2oP... R~10
14. Do the receiving crops differ 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?
Page 2 of3
0 Yes
DYes
DYes
D Yes
D Yes
D Yes
DYes
00ther:
D Yes
[52{ No DNA ONE
g'No DNA ONE
[3'No DNA ONE
gNo DNA O NE
G}'No DNA ONE
[3'No DNA ONE
u{No DNA O NE
5f'No
11412011 Continued
jDate of Inspection: s/Or)l~ I
!Facility Number:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes. check
the appropriate box(es) below.
0 Yes ~No
DYes 5(No
DNA ONE
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 of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility'! If yes, check the appropriate box below.
DYes 0 No
0 Yes D No
DNA ONE ~NA ONE
DYes ~Yf"No DNA ONE
DYes (Sd'No DNA D NE
DYes !;Z(No DNA ONE
D Yes I9"No D NA D NE
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. Docs the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of3
DYes gNo
DYes ~No
DYes [3"No
DNA ONE
DNA ONE
DNA ONE
Phone: ct\D · 3 ~D-~cos\
Date: 5 \o\\ \ ")....
'
21411011
;
Operation Review Structure Evaluation
0 Follow-u 0 Referral 0 0 Other
Date of Vl•it' ~ ArrivaiTime' 1/0~ Departure Timed lit /tiiJ.. County'~ Reg;on' F12/)
Farm Name: ~~tc: ~<) ~ Owner Email:
Owner Name: Phone:
Mailing Address:
PhysicalAddress: ----------------~--------------------------------------------------------------------
Facility Contact: {!ur/ts ~~cL Title: ~-~. Phone:
Onsite Representative: a~.$ &rrc.i(~ Integrator: ~...,.~
Certified Operator: ~ l:f!l::i:,.f--6~,..-~ertificatioo Number: Jf'6t:' Ia
Back-up Operator: Certification Number:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed trom any part of the operation?
Di scharge originated at: D Structure 0 Application Field
a. Was the conveyance man-made?
D Other:
b . Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume tha t reached waters of the State (gallons)?
d . Does the discharge bypass the waste management sys tem ? (If yes, notify DWQ)
2 . Is there evidence of a past discharge from any part of the operation ?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
Longitude:
DYes ~0NA ONE
DYes 0 No ~ONE
DYes 0 No ~ONE
D Yes D No [iii: 0 NE
DYes ~ DNA ONE
DYes ~ DNA ONE
21412011 Continued
I Date of lnspectioJ~/ //
I
I Facility Number:
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 1
#I
Structure 2 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~ DNA ONE
0 Yes D No [g-t(A D NE
Structure 5 Structure6
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 DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
11 . Is there evidence of incorrect land application? If yes, check the appropriate box below.
DYes~ DNA ONE
DYes ~ DNA ONE
D Yes~ DNA ONE
DYes~ DNA ONE
DY es~ D NA O NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 H eavy Metals (Cu , Zn, etc.)
D PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure t o Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12 .CmpType(s) ~ ~~/ 5f'<K)
13.Soi1Type(s): ___ _
14 . Do the receiving crops differ fro m those des ignated in theCA WMP? 0 Yes ~DNA ONE
0 Yes [31fo DNA 0 NE
0 Yes u;;rr:ro 0 NA 0 NE
I 5. Does the receiving crop and/or land application s ite need improvement?
16. Did the facility fail to sec ure and/or operate per the irrigation d esign or wettable
acres deterrnination?
17 . Does the facility lack adequate acreage for land a pplication'?
I 8. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the fa c ility fail to have the Certifi cate of Coverage & Permit r eadily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
owuP O checklists D Design 0 Maps D Lease Agreements
21. Does record kee ping need improve ment? Ifyes, check the appropriate box below.
DYes
0 Yes
D Yes
DYes
00ther:
D Yes
~ D NA O NE
~0 D NA ONE
0"No DNA ONE
~0 DNA ONE
~ DNA ONE
D Waste Application 0 W eekl y Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste T ransfers D Weather Code
0 Rainfa ll 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey
22. Did the faci lity fail to install and maintain a ra in gauge?
23. If selected, did the facility fa il to install and maintain rainbreakers on irrigati on equipment?
Page 1 of3
DYes ~
0 Yes 0 No
DNA ONE
~ONE
2/411011 Continued
jFacility Number: !Date oflnspection: ~ ::z2z I
J
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes
25. Is the facility out of compliance with permit conditions related to sludge? lfyes, check 0 Yes
DNA ONE
DNA ONE
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 provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below .
0 Application Field 0 Lagoon/Storage Pond 0 Other:
DYes
DYes
DYes
DYes
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? 0 Yes
34. Does the facility require a follow-up visit by the same agency? DYes
~ DNA
0No [B'1iJA
~0 DNA
~0 DNA
~ DNA
~ DNA
~ DNA
~DNA
~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).
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/Inspector Name: Phone: 1/£7 -1i3 -:-3 ?x?fJ
Dat{/jf=//J
114/ZOll
Reviewer/Inspector Sioo~~-===~~g~~~;;.:Jp.~~~~~L------------------------­
Page3 of3
2 -oS-2o!O
ompliance Inspection 0 Operation Review 0 Technical Assistance
Reason for Visit ~ne 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I!-29-10 I Arrival Time:l/t> ,' oo.,l Departure Time: l;o: ~ I County:
~ { . s. --+•A,.
Farm Name: ~ i N C a' r "w /c:c. ~~'"-Owner Email: ---------------------------
Region: F/20
Owner Name: Cav /fo"' Bave.. P6?J +-Phone:
MailingAddress: ---------------------------------------------------------------------------------
Physical Address:----------------------------------------------------------------
Facility Contact: _L.=-q.....:...._rh_ . ...;_·.::..s___;;i3;;;._Gt_v_...J_i_<....;;.;.i( ___ Title: / ~ • ;y~t:... · PhoneNo: ________________ __
Onsite Representative : -------------------------------------Integrator: __ ....;Ca:.-_t.._' _c.._ ..... _,_· <-__ h __ tl._v_~__;'-----------
Certified Operator: ---------------------------------------Operator Certification Number: ---------------
Back-up Operator: -------------------------------------Back-up C ertification Number:
Location of Farm: ,------,
0 D · D .. Latitude: L__J Longitude:
Discharges & Stream Impacts
I. Is any di sc harge obse rv ed from any part of th e o pe ratio n? DYes 81(io 0 NA 0 NE
Disc ha rge originated at: D Struc ture 0 Applicati o n Field 0 Other
a. Was the conveyance man-made?
b. D id th e d ischarge reach waters of the State? (I f yes, noti fy DWQ )
c . Wh at is th e es tim ate d vo lume th at reac hed waters o f th e S tate (gall on s)?
d. Does di scharge bypass th e was te manageme nt system ? (If yes, no ti fy DW Q )
2 . Is there evide nce o f a past di scha rge fr om any pa rt of th e operati o n?
3 . Were th ere a ny adve rse impacts or pote nti al adve rse im pacts to th e Wate rs of the S tate
o th e r th an from a disc harge?
D Yes 0 No B'NA ONE
D Ye s 0No ~A O NE
1
D Ye s 0 No ~ ON E
D Yes B'N'o D NA O NE
D Yes 81fo D NA O NE
11128104 Continued
I Facility Number: B2-b2'll Date of Inspection [7-2 ?-1 0 I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure l Structure 2 Structure 3 Structure 4
DYes
DYes
~DNA ~DNA ONE
ONE
Structure 5 Structure 6
Identifier:------------------------------------------
Spillway?:
Designed Freeboard (in): ----....,..--------------------------------------
Observed Freeboard (in): ---=31J11;=-.;....;;2;;;;....:(,~ -----------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
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 DWQ
7. Do any of the structures need maintenance or improvement? 0 Yes ~ 0 NA 0 NE
8. Do any of the stucturcs lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~DNA ONE
DYes ~DNA ONE
ll. Is there evidence of incorrect application? lfyes, check the appropriate box below. 0 Yes ~ 0 NA 0 NE
0 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 0 Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s) -~B.~· ~::::r.=-=· M:.:.:..::"-:.!:~::.:~==:..._(.:....:._~_t.....,J'----:,~· ...:f?.-...::.::.::s~c..~i.t~~~0....::G::..r.:...:;~;z'~c..::.::)~,___.lS~~:!.:d::.:...I....:G::::..:..:.--e<J~·"':...._..:..~..:..()_, _> _· _) ____ _
13. Soil type(s) /loA Rt:t Go .If
14. Do the receiving crops differ from those designated in theCA WM P? DYes ~DNA ONE
15. Does the receiving crop and/or land application site need improvement? DYes ~DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes ~D NAD NE
17. Does the facility lack adequate acreage for land application? DYes ~DNA ONE
18. Is there a lack of properly operating waste application equipment? DYes ~·DNA ONE
to question #): El'P'~i~!:~iilY,;•)JE:s answers and/or any re•:ornn•eiitdattifi,ris(o"r··'a ny (Jith,ercoJrnlllleo
rin .. ;infio;::,nf facility to better (use additional pages as ne•~essar-y,,:::
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone: Cf/(), Y3'3, 33t>O
Date: /-2 <J -2.0/ D
12/28104 Continued
'"
I Facility Number: 82-62.1/l Date ofl nspection k-Z 9 -I 0 I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components ofthe CAWMP readily available? If yes, check
the appropriate box. D WUP D Checklists D Design 0 Maps 0 Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes
DYes
~DNA
~DNA
ONE
ONE
DYes ~ DNA ONE
D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rain Inspections · D Weather Code
22. Did the facility fail to install and maintain a rain gauge?
-23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notifY the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
DYes~
DYes~
DYes~
DYes~
DYes C3'No
DYes ErNo
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
12/28104
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
Type of Visit -~o~liance Inspection 0 Operation Review 0 Structure Evaluation
Reason for Visit efftoutine 0 Complaint 0 Foll:w up 0 Referral 0 Emergency 0 Other D Denied Access
DateofVisit: 11-11-0q I ArrivaiTime:l<f,'.2.rA--I DepartureTime: I1.'1>Jh-.l County: Region: piUJ
Farm Name: 51 ,..,cl at f"" So vJ hi rr-""""'-Owner Email: ----------------------------
Owner Name: Ca.r I +a"' "&..vc.fi>o 1-Phone:
Mailing Address: -----------------------------------------------------
Physical Address: --------------------------------------------------------------------
Facility Contact: Cur+t~ 8o..rwit:Jc_ Title: 7~. sPec.. • •
PboneNo: ________________ _
Onsite Representative: -------------------------Integrator: ---=G=o_h-=--P._y-_;,:..... ~_;:....---=.Fa__---=~_;:_-=-----
0
Certified Operator:----------------------------Operator Certification Number: ------------
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? 0 Yes B1fo 0 NA ONE
Discharge originated at: 0 Structure 0 Ap plication Field 0 Other
a. Was the conveyance man-made?
b. Did th e discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estima ted volume that reached waters of the State (gallons)?
d. Docs discharge bypass the waste management system? (If yes , notifY DWQ)
2 . Is there evidenc e of a past discharge from any part of the operation?
3 . Were th ere any adverse impacts or potential adverse impacts to the Waters of the Sta te
oth er than ffom a discharge''
DYes 0No ~A ONE
DYes 0No G;;}NA ONE
I
DYes 0 No B"NA ONE
DYes ~0 DNA ONE
DYes ~ DNA ONE
12/28104 Co ntinued
!Facility Number:B2 -t,Z4l! Date of Inspection 19'-!]-0 j I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
DYes ~o DNA ONE
D Yes Gf"N'o D NA 0 NE
Structure 5 Structure 6
Identifier:-----------------------------------------
Spillway?:
DesignedFreeboard(in): ___ """'T. ____________________________________ _
3 ~ ;,
Observed Freeboard (in): --"-""'-=~~-----------------------------------
5. Are there any immediate threats to the integrity of any ofthc structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Arc there structures on-site which arc not properly addressed and/or managed
through a waste management or closure plan?
0 Yes B"No DNA D NE
DYes B'No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? DYes ~o DNA 0 NE
8. Do any of the stucturcs 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
l 0. Are there any required buffers , setbacks, or compliance alternatives that need
maintenance/improvement?
DYes B'No DNA ONE
DYes E3"'No DNA D NE
DYes l3'No DNA 0 NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes E:f"No 0 NA D NE
D Excessive Ponding D Hydraulic Overload 0 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
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12. Crop type(s) B'-Y~v...d-{JI"'-"1)
1
F~~C.4 c_ ( Gn:i U
1
S....-..t/ 6..-o.,',..J ( o.s.)
13. Soil type(s) N() A R~ G 0 A
14. Do the receiving crops differ from those designated in theCA WMP? DYes ~0 DNA ONE
15. Does the receiving crop and/or land application site need improvement? DYes B'No DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? DYes ifNo DNA D NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
DYes EfNo DNA
DYes ErN'o DNA
Phone: &j/(J, '/33.333
Date: 9-11-Z-00 CJ
ONE
ONE
12128104 Continued
I Facility Number: 82 -~2'11 Date oflnspection jq-t7-b 11
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box. D WUP D Checklists D Design D Maps D Other
DYes E(No DNA ONE
DYes ffNo DNA D NE
21. Does record keeping need improvement? lfyes, check the appropriate box below. DYes ~o DNA D NE
D Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Analysi s D Waste Transfers D Annual Certification
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and I" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes C31Jo DNA ONE
.23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes ffNo DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~0 DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes l3"No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes ~0 DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes £:3"N'o DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes ~0 DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes B1.lo 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 B"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 DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
[31(i'o 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes DNA ONE
33. Does facility require a follow-up visit by same agency? DYes ~ DNA ONE
-1 • : ... ~4<' : • ~ --' ,._ • , ' : • ""' • ,' -• • ~ ~ .,_
12/28104
.. Biu,ts q-oS"-08 R.IL
(Facility Number I H IP2'f II 9'15ivision of Water Quality
~2 0 Di\'ision of Soil and Water Conservation
0 Other Agency
Type of Visit Er'Compllance 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 0 Den i ed Access
Date of Visit: 16'-/ 7 • tJ el Ar r ival Timed /t'J tltJ.tM! Region: r£B
Farm Name: .s;;tcAttY. Saw PZl;r-.. Owner Email: -------------
Owner Name: Cav-ffoA.J &:<v-e~c.f.;, ________ _ Phone:
Mailing Address: ----------------------------------------
Physical Address:----------------------------------------
Facility Contact: Cu tc-h 1,; 13o..y I...JI (:.. K.. Title: I~ • .Spu:_ ;
I
PhoneNo: ___________ _
Onsite Representati\'e: Uta\ iMt"l61, 1::. A::. Integrator: Co ~a.y i <
Certified Operator: :f "-lii1.C:.S iJoJW h,_c:u.l~::.:.;if.:....<::_e,r....:....._ _____ _ Operator Certification Number: '!~513 2-
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD 'D " Longitude: D OD'D"
Swine
ID Wean to Fini s h
0 Wean to Fe eder
0 Fe eder to Fini sh
lXI Farrow to W can
0 Farrow to Feeder
0 Farrow to Finish
0 Gilts
0 Boars
Other
ID Other
Design
Capacity
/250
-
Discharges & Stream Impacts
Current
Population
119 $'
Wet Poultry 10 Layer
Dry Poultry
D Lav ers
0 No n-La yers
0 Pullets
0 Turkeys
0 Turkey Poults
D Other
I . Is any discharge observ ed from an y part of th e o perat io n?
Design Current
Capacity Population
I I
Disc harge o ri g in ated a t: 0 S tructure 0 Application Fi e ld D Other
a . Was the conveyance man-made?
b . Did th e di sc harge reac h waters of the S tate? (If yes, notify DW Q)
Design Current
Cattle Capacity Population
0 Dairy Cow
f 0 Dai rvCalf
0 Dairy Heifc1
ODrv Cow
0 Non-Dairy
0 Beef Stockel
0 BeefFeeder I 0 Beef Brood Cov. ' -. -·---· -
Number of Structures: ITJ
D Yes ~No DNA O N E
DYes 0No ~NA ONE
DYe s 0No [&iNA ONE
c . Wh at is the e st imated vo lume that reached wa ters of the State (ga llons )? I
d . Does di sch arge bypass th e waste managem ent system? {If yes, no tify DW Q)
2. Is th e re eviden ce of a pas t di scharge fro m an y pa rt o f the operation?
3. Were there any adverse impact s or pot enti al ad ve rse impacts to the Waters of the State
oth er than from a d isc harge?
DYes 0No
DYes lXI No
DYes ~N o
12118/04
~NA ONE
DNA O NE
DNA ONE
Continued
jFacility Number: ~Z-b2( I Date of Inspection I 8 -!9~el
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
DYes ~No DNA ONE
D Yes [!I No D NA 0 NE
Structure 5 Structure 6
Identifier:----------------------------------------
Spillway?:
Designed Freeboard (in): ----~-----------------------------------
2 ~"
Observed Freeboard (in): _ __..;;;~[)=-------------------------------------
5. Arc there any immediate threats to the integ rity of any of the structures observed? DYes
(ie/ large trees, severe erosion, seepage, etc.)
ll!J No DNA ONE
6. Are there structures on-site which are not properly addressed and/or ma~aged DYes
through a waste management or closure plan?
[BNo DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits , dry stacks and/or wet stacks)
9. Docs any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Arc there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
DYes cyJNo DNA ONE
DYes r;i'No 0 NA 0 NE
0 Yes ijill No DNA ONE
II . Is there evidence of incorrect application? If yes, c heck the appropriate box below. 0 Yes ~o 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN > 10% or 10 lbs 0 Total Phosphorus D 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. Croptype(s) l?er&tld~ {?;;~1 ~, St<g// &i7J.:,v (o,s,)
13. Soil type(s) .tloA Ra< . Go> A
I ;
14. Do the receiving crops differ from those des ignated in theCA WMP?
I 5. Does the receiving crop and/or land a pplication s ite need improvement?
D Yes
DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?D Yes
17. Does the facility lack adequate acreage for land applicati on?
I 8. Is there a lack of properly operating waste application equipment?
DYes
D Yes
r:l9No
~No
~No
~0
~No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Gr.;/)d -I kYi-"£
b~od. . cl I Re<....&>Y'i S . ,, ;'I
Goo<l Dp<--YZ<. -/zrv ...l v ~ ~ w, F~v...;(~..,..--
-,e,/!. ••• L-
DNA
DNA
DNA
DNA
DNA
ONE
ONE
ONE
ONE
ONE
...
f.-
1-...
Reviewer /Ins pector Name _-g•'t:.-K-..... 12 e," c..i ..r Phone: '11~. Y33.~330
Reviewer/Inspector Signature: rfd~~ Date: S -19-zooB
12128104 Contmued
. . . ""
I Facility Number: ~2--bz¥1 Date of Inspection 16-i9-~ B]
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. D WUP D Checklists 0 Design D Maps D Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes [gJNo DNA ONE
DYes lfJNo 0 NA 0 NE
0 Yes !if) No 0 NA D NE
D Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers D Annual Certification
D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes liJNo DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes ~No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes (11No 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 £1No 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? 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 'IJNo 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 OJ No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes i;BNo DNA ONE
33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE
Page3 of 3 12128104
I Facility Number I II 8 .Di v ision of Water Quality tV"
~2 H~zSt 0 Division of Soil and Water Conservation
.. 0 Other Age ncy
Type of Visit 8 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 8 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Departure Time: j9.st:~_,_ I County: ~"':,p.S~<.V Region : rk!o Date of Visit : VD-t>3 -o "71 Arrival Time: l9.~0AH
Farm Na me: S/,..u::.(q; r Sow HLv""""-
Owne rName: Ctl.+-Jkd B. 6£..--c..lf:. f-
Owner E m ai l: --------------
Phone:
Mailing Address: -----------------------------------------
Physical Address:------------------------------------____ _
Facility Contact: ~rA$ &rw, (;Jc:; Titlt-: __:./Sv:;;;..;..;..:"-;..:.'-..:./l(...:i,1.;r.i-.......:...· ----Phone No:---------
Onsite Representative: C"V,l, :S &tyi..J :·e:.. K Integrator: -~C_,llw:;..A.:...~;;.;;;;....;;...¥..:..;...;. ~=-_r._.-...;Q..;.I"....;~;.;....., ... S.::..-__ _
Certifi ed Operator:--------------------Opera tor Certification Number: -------
Ba ck-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 Capa city Population Cattle Capacity Population
ID Wean to Fini sh I I
0 Wean to Feeder
0 Feeder to Finish
0 Dairy Cow l
I I
0 Dairy Calf i I 0 Dairv Heife1
10 Layer
0 Non -Laye r
(gl Farrow to W can 12So /2{)~
0 Fa rrow to Fe eder
0 Farrow to Finish
0 Gi lts
0 Boars
0 Dry Cow
0 Non -Dairy
0 Beef Stocker ! 0 Beef Feeder I 0 Beef Brood Cow
••<•• -·· -· ---
Dry Poultry
0 laye rs
0 Non-Layers
0 Pullets
0 Turkeys
Other 0 Tu rkey Poults
0 Other ID Other Number of Structures: CZJ :
Discharges & Stream Impacts
1. Is any d ischarge observed from any part of th e opemtion? 0 Yes ~No D NA O NE
Di scharge originated at: 0 Structure D Appli cati on field 0 Other
a. Wa s the conveya nc e man -made? D Yes ~No DNA ONE
b. Did the discharge reac h waters of the State? (If yes, no tify DWQ) D Yes ~No D NA O NE
c. What is the estimated vo lu me that reached wate rs of the State (gallons)?
d . Docs discharge bypass the waste man agement system? (I f yes , notify DWQ)
2. Is there evidence o f a past discharge from any part of the operation ?
3. Were there any adverse impact s or potential adverse impacts to the Wa ters of the State
other than from a di s c harge?
D Yes og No
D Yes ~No
DYes ~No
12/28104
D NA O NE
D NA O NE
D NA ONE
Continued
..
!Facility Number: 32 -~21/ I Date of Inspection V~3~t7 71
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure l Structure 2 Structure 3 Structure 4
DYes ~No DNA O NE
DYes ltJNo DNA ONE
Structure 5 Structure 6
Identifier:----------------------------------------
Spillway?:
Designed Freeboard (in): ----------------------------------------
Observed Freeboard (in): 95
5. Are there any immediate threats to the integrity of any of the structures observed? DYes
(ie/ large trees, severe erosion, seepage, etc.)
12!1 No DNA ONE
6. Are there structures on-site which arc not properly addressed and/or managed DYes fig No DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and tbe situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the penn it?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes lli No DNA 0 NE
D Yes ~No DNA ONE
II. Is there evidence of incorrect app li cation? If yes, c heck the appropriate box below. 0 Yes ~No 0 NA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metal s (Cu, Zn , etc.)
0 PAN D PAN > 10% or 10 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
14. Do th e receiving c rops differ from those de signated in theCA WMP?
15. Does the receiving crop and/or land application s ite need improvement?
D Yes
DYes
16 . Did the facility fail to secure and/or operate per the irrigation desi1:,rn or wettable acre dctcnnination?D Yes
17 _ Does the facility lack adequate acreage for land applicat ion?
18 . Is there a lack of prope rl y operating waste app li cation equipment?
DYes
DYes
[i)No
liJ No
00No
00No
~N o
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
tlo-1< ; P/~.Jc woYIL ~,.) iNV•-:.S;V L tj rt:.$ .Sl'S.
DNA
DNA
DNA
DNA
D NA
Reviewer/Inspector Name Phone: 9/tJ. f..33. 33lJO
ON E
ONE
ONE
ONE
ONE
...
f--
1-...
l<ic.K~ Ke"~ t.s
Reviewer/Inspector Signature: f? ;;A.. ~ Date : /0 -0.3-Z.Ot>] -12128104 .
"' ....
I Facility Number: 1/2. -~¥-1
Required Records & Documents
Date of Inspection ~-t:f~ -o 71
19 . Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other
DYes ~No D NA 0 NE
0 Yes QfNo 0 NA 0 NE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~-No 0 NA O 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 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes IE No DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes {11 No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes 00No DNA ONE
25. Did the facility fail to conduct a sludge survey as required b y the permit? DYes ~No D NA O NE
26. Did the faci li ty fail to have an actively certified operator in charge? DYes ~No DNA O NE
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? DYes ilJNo DNA O NE
29 . Did the facility fail to properly dispose of dead animal s within 24 hours and/or document DYes l:8JNo DNA O NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes !)a No DNA O NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes ~No DNA O NE
General Perm it? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/In spector fail to discuss review/inspection with an on-site representative? DYes liJ No DNA O NE
33. Does facility require a fo ll ow-up visit by same agency? D Yes ~No DNA O NE
Additional Comments and/or Drawings:
....
1-
1-.....
12/28104
Type of Visit ~ 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: 1.5'-o~-0~ I Arrh'al Time: l;o;oo.q.-1 Departure Time: ._1 ___ ___,1 County: Sa-.,~""' Region: r~
FarmName: -~~~'~'n~c~l~~ur~V'-~~~o~~~~f;~a~~~~~~------­
Owner Name: __ C_o._v-_1-'t<"--o"""'r-J..;.___...::B~. __ B~v~.fsro±
Owner Email: --------------
Phone: (CJto) S9t-/374-
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: Cuv+rs &.vwt(.,k._ Title: -----------PboneNo: __________ _
Onsite Representati\'e: ----------------------Integrator: C oha H ~
Certified Operator: C ~ l +a 1--J Operator Certification Number: / Z 795
Back-up Operator: --------------------------Back*UP Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes ~No DNA ONE
Discharge originated at: D Structure D Application Field D Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters ufthe State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
DYes ~No DNA ONE
DYes [X No DNA ONE
DYes ~No DNA ONE
DYes QilNo DNA ONE
DYes ~No ON~ ONE
12118104 Continued
I Facility Number: ~2..-~ 2 jl I Dateoflnspectiun IS-09-olol
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
DYes ~No DNA ONE
DYes ~No DNA ONE
Structure 5 Structure 6
Identifier:-----------------------------------------
Spillway?:
I Q lr
Designed Freeboard (in): __ ...J_:.......L.L ___ -------------------------------
. ,,
Observed Freeboard (in): __ __.9-'----'0:::...._ __ -------------------______ ------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/large trees, severe erosion, seepage, etc.)
DYes ~No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes r)?l No 0 NA 0 NE
DYes ~No DNA ONE
DYes ~N o DNA ONE
DYes [}lNo DNA D NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~No 0 NA D NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN D PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare So il
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12. Crop type(s)
13. Soil type(s)
} I
Whe.B I; /JI4vAvNtud57 &..sat<...,... ,· K~l.,._, rJWJ~c .... ~
Gotdsboro
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
DYes
DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination 'i O Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
DYes
DYes
15?:1 No DNA ONE
00No DNA ONE
~No DNA ONE
ri1 N o DNA ONE
!M'No DNA ONE
Reviewer/Inspector Name
Reviewer II nspector Signa tore:
~~~~~~~~~~~ Phone: ~~~~---------­
Date:
11118104 Continued
[Facility Number: <62. -~2il
Required Records & Documents
Date of Inspection l5-o9-o~l
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. D WUP 0 Checklists D Design D Maps D Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes (giNo DNA ONE
0 Yes ~No DNA ONE
DYes ~No DNA ONE
D Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers D Annual Certification
D Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakcrs on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notifY the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
12128104
~No DNA ONE
1:8'No DNA ONE
0No mJNA ONE
0No ~NA ONE
~No DNA ONE
~No DNA ONE
~No DNA ONE
~No DNA ONE
I&JNo DNA ONE
l]f'No DNA ONE
ll;l No DNA ONE
(X No DNA ONE
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\'isit: 13 ·II~ I Arrh·al Time: lll ::Jr.,,. I Departure Time: IL..--___ _.1 County: 5-""tl'&M Region: F=Ro
Farm Name: S:a c. ftt .c Sow EDrm Owner Email: --------------
Owner Name: btl.cL.f.,l!J 8.. Bs.u.~of-
Mailing Address: c/o t?I!~Q.·I). .S:.·.a iC ',·!: Lt(,,ot. K~~u. u c. /;,6,, 11/L
Physical Address:-----------------------------------:::::---------,:::_,..,
F acili~· Contact: C wf,j 13&ew .e. /( Title : Phone No: Cf1t)-~(, Lf-'f'i't I
Onsite Representati\'c: Cvl$ 4•ctr ;;.,/<1 t.tl, 4«e~Jf!ll!cs 6.J4.Integrator: -..::C.:..:•~~.!:!o/~l,s;·t: ___________ _
Certified Operator: ( a.r/f..oq 8acctbof= Operator Certification Number: I? ? C,~
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm : Latitude: D OD'D" Longitude:
Discharges & Strea m Impacts
1. Is any discharge ob served from any part of the operation? DYes ~o DNA ONE
Di scharge originated at: 0 Structure 0 Application Field D Other
a. Was the conveyance man-made?
b. D id the discharge reach waters of th e State? (If y es. notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d . Does discharge bypass the waste management system? (If yes , notify DWQ)
2. Is th ere evidence of a past discharge from any part ofthc op eration ?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
D Yes D No DNA ONE
D Yes D No DNA O NE
D Yes DNo DNA ONE
DYes B"No DNA ONE
DYes B'No DNA ONE
12/28/04 Continued
[Facility Number: I~ -{,..2'1 Date of Inspection I 3 -I f·OS: 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
DYes ~o DNA ONE
DYes DNo DNA ONE
Structure 5 Structure 6
Identifier: ---·Lt ___ -----------------------------------
Spillway?:
Designed Freeboard (in):------------------------------------------
Observed Freeboard (in): __ 4 ...J'1LLI_"' ___ --------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes GJ1ilo 0 NA 0 NE
6. Are there structures on-site which are not properly addressed and/or managed DYes 0'N'o 0 NA D NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits. dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
0 Yes Q-'No DNA 0 NE
DYes £3"No 0 NA 0 NE
D Yes G3"'No 0 NA D NE
DYes l:a"No DNA ONE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes ~o DNA D NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
,,'7 t]J. 1'1'1 ,~ /(~o ;)fA>_.~?r ~o
12. Crop type(s) ---"C"""'a:z..c~n~----'So,r::?A:Z;;u=6~,~qt!,L.!S;___~lv.!J.Ir~r~,;ai:...____JW,~ . .a·a~l,t.J.c::.._~!l~,tOeu.uel(.o..•~4=---___!h::J~~.c;~c;~v:..¢('~-&~e:c..ce~":&o~'A.!:4-, _ _.S:a.i!lr:a.•ll&.!:l6wimtic•,__
13. Soil type(s) Al~cfo//( J /(q,;?5 1 Geld.sbwo
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
0 Yes [;}No
DYes Q-1<ro
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination! 0 Yes D No
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
DYes 0No
DYes ~o
·--.. .., -· . .; --~ --~ ·' ... "' .... ~ . .. -... ,.
Comments (refer to question #): ·Explain 'any YES answers and/or any r«.~mmendations or any other comments.
Use drawings offacility to.~etter explaill, situations. (use additional pages as ·n~essary):' ·~ .. · ·, --J-.: ...... ' . ', ....
DNA ONE
DNA ONE
DNA ~E
DNA B"NE
DNA ONE
Reviewer/Inspector Name 11'11~,..1' -~ IJr-~"' ' J Phone: ~ 9~&. ·tflf/crf'JJo ~~~~~~~~~--~------~------~
Reviewer/Inspector Signature: ?>t-A_ /1. '-~ Date: 3·11·(1 ~
v 12/28104 Continued
\ ..
I Facility Number: g ;z -~;)i j Date of Inspection I J -/j•-zJf'""l
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 ~ 0 C~sts l3L>esign 0 ~ 0 ~
G?Y'es 0No DNA ONE
0'Yes 0No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. ~-J ~-'1.1. 0 Yes G-No 0 NA D NE
""-tr-> 1.7 '' ,,~ /.'( •en
0 Wftsh! Apf!lieetion 0 Weekly Fieeb01tl'd D Weste Aaal~·sis D Soil Analysis D Waste Transfers D A:tmual CertJftcafion
D-Rain fall D ~teeliiRg--O~p Yitil& 0 129 Minute lnspectlohs 0 Mortthl' aFta I" RsiR IRi~wctiaas D Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge. freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
1 er. T),~ I'J~W ~rl;l'.·caf~ 0~ c.-t'~~ &..,t,) l'r-,-..,:1-J, .. 6 ,,... h~~,.
I ll.SI'~e f.,.,. .... rtr
:2-0. PI~D.St ,t)kr~
q I. j": I se"'''l' &,J
f'"'S$.·J./t'.
,.,~,·t &t . ,t'IV
A Co,.o I' D~
~ C"Jf7 ~.,{
H, k_,e~ • ., ~ do.~.,., '" F11,.,.,
DYes 0No DNA ONE
DYes QNo DNA ONE
DYes 0No DNA G}'tqE
DYes 0No DNA G}1qt
DYes ~ DNA ONE
DYes 0No DNA ~
DYes l!J-No DNA ONE
DYes ~0 DNA ONE
DYes ~0 DNA ONE
DYes 13'No DNA ONE
DYes [3"No DNA ONE
DYes [31-.lo DNA ONE
r~u,·~~~"-1 y~f.
r4e~
1211&104
r:nr..,nlii::anr'"• Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ~outine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other D Denied Access
~acility Number 1 &;I H ,,.,. I Date or Visit: I S'/~q.l hime: I 1/: DO I
. )O Not Operational 0 Below Threshold I
lil'Pennitted liii'Certified [J Conditionally Certified C Registered Date Last Operated or Above Threshold: ·---·--·-···-·
Fann ~ame: ..... C.~?..:.-~~ ... L~ ..... S. M~!. .... :?.:.~----~--County: ---~p..!.!L ... ·-·······----·---·------·
Owner Name: ___ .c_:~---···-~U.LJ? .... S.!'.rY:Jai..c. .......... -.. ·····--·-·· .Phone No: _____ $~~q._::__~-~-~-~----·------·-·-----·-·
Mailing Address' .. _'f~ __ f«..!f!:~--tJ_,_(,J;_!clraJ.1 .. __ .AL_ _____ Ii_w_ ____ ----···
:~ .. ey:=~-=~~-;-~:t:;·--··· Tid., ·--~-~----=----a~ No: --------------··
p ··-·------------------------·-····-·······-·-·-··········--·· Integrato __________ c.. ________________________ _
Certified Operator: ··-··---~li.11.~.-----·· -~±·········-··-···-·······-··· Operator Certification Number: ___ [_11!J.$ _______ _
Location ofFann:
Swine D Poultry 0 Cattle 0 Horse Latitude .___ ..... I• ... I _ __.I' ._I _ __.I" Longitude
Discharges & Stream Jmpacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Lagoon 0 Spray Field D Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is obs erved , did it reac h Water of the Stale? (If yes, notify DWQ)
c. If dis charge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon syslem ? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Wa ters of the State other than from a dis charge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? 0 Spillway
Structure 1 Structure 2 S tructure 3 Structure 4 Structure 5
Identifier: ·········--·'···················· .............................. -... ··-····--······ .. ······--·········· ................................. _
DYes [!11ilo
DYes 0No
DYes DNo
DYes 0No
DYes ~0
DYes ~0
DYes ~0
Structure 6
'?a"
Freeboard (in ches): __ .::::~....:~~~:__ __ -------------------------------
12112103 Continued
jFacility Number: ~~ Date of Inspection I S/.:ls M I
5: Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate pnblic health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes , check the appropriate box below.
D Excessive Pending D PAN 0 Hydraulic Overload D Frozen Ground 0 Copper and/or Zinc
12. Crop type ~ 1 So:J~1 J. t; wi"A. tbl,..
1
fer~, 4}~
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19 . Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
+;) 1-... ~st,J,/;d, .fh ~s.c~
,.,_~;J J,.~,.vt. l,-Jts 4, kor ~+.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
12112103
DYes []"No
DYes riNo
DYes ~0
DYes ~0
DYes ~0
DYes ~0
DYes &1ifo
DYes ~0
DYes ~0
DYes ~0
DYes ~0
DYes ~0
DYes [!!'No
DYes ~0
DYes ~0
DYes ~0
DYes ~0
j Facili~ Number: g,. -~I Date of Inspection I S/.!$7d I
Required Records & Document-;
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
0 Waste Application 0 Freeboard D Waste Analysis D Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25 . Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
28 . Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified A WMP?
NPDES Pennitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33 . Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
D Stocking Form 0 Crop Yield Form D Rainfall D Inspection After 1" Rain
0 120 Minute Inspections D Annual Certification Form
DYes
DYes
D Yes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
C No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
-s.; J s~fd -.J ~~ s.-r~~ J,~ * ~lte 4:\ .. J ~..J..
-I:""" -~ •(fltecl Q hG~-clcJ r-4~
.. f-r :) l'e~Js, ~k ~< •"'J ~ 14(' 'k> ~1e.
12112103
~f Ar-;J I
1
... ~ir.c H·)
~0
~0
(31:io
DNo
DNo
DNo
ONo
DNo
ONo
~0
DNo
0No
ONo
ONo
DNo
r-...
Site Requires Immediate Attention: -~-­
Facility No. ~~~----
DMSION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
* .. -. .. ~ <)Q..'"' ""'"1"
"S ~ .,. u. ·"'.s
DATE: \{ ~ , 1995
Time: }"-oo
Farm Name/Owner: S'..., '-\.f\ lQ. H co. e. f-.. "it."'
·Mailing Address: , ~+ . ~ B. o )(. \oe ~
County: "SP.-.r,•"
Integrator: · C.o"'-,,.:~ Phone: S"":L· o\o5"
On Site Representative: ';) .. "" .. s <$'"-=-\.,.;... Phone: "S''"{-G.'t '"\
Physical Address/Location : \.o' ~ · f"r·-~\..,t,, . Go 'To 'k-~~c..--r~l\. ~
0"" \<.c..e,."'-Lr ~ ~ n~Gp $ n.,, ...... (\1\d=
Type of Operation : Swine 1. Poultry__ Cattle----------------
Design Capacity : \ "L'S o Number of Animals on Site: t 'l.So -=o-w .(;. • ....,
DEM Certification Number: ACE.___ DEM Certification Number: ACNEW ______ _
Latitude: __ o __ __ .. Longitude : __ o __ • __ "
Circle Yes or No
Does the Animal Waste Lagoon ~sufficient freeboard of I Foot + 25 year 24 hour storm
(approximately 1 Foot + 7 inches) ~or No Actual Freeboard : \ l Ft. __ Inches~
Was any seepage observed from the l~n(s)? Yes o@ Was any erosion o~? Yes or~
Is adequate land available for spray? ~or No Is the cover crop adequate?. Yes r No
Crop(s) being utilized : ""-·" ~ ~ \u. a.u o.Vo. .\.. 1
Does the fac ility meet SCS minimum setback criteria ? 200 Feet from Dwelli~? e or No
100 Feet from Wells? Yes o~
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? es or o · \3
Is an imal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue me: Yes No
Is an i mal waste discharged into water~ state by man-made ditch , flushing system, or other
similar man -made devices? Yes o~ If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No ...:~.~ "T <t llfn.~
Additional Comments: 3 ~C.. I ro '-d .. t'\, "Q ~-rn ~
\ \.-s "-c..rc.. \,~eo
Inspector Name Signature
cc : Facility Assessment Unit Use Attachments if Needed .
event
i
Pl .. •• :-•tu:: th• CCIII!Pl•t~ ~o::= to the Divi.eion o~ b.Vi.:oz=e,n:al Kanag-=ant at
the ad~••• c.: the :-eve:•• •ida of' thi.• f'o=.
Name of farm (Please print)-:_,......,. __ -_s_-.:....;..;:"-:....:'::.::·...:./_a....:,_,. __ H;....:....,":..~·.,;;"~.:....F...:";,;_;_r....;-~· -------------
Address: ~.,. 7 B-.-loY.' A
C i,'-..,._., cr.::;.. ?c.-3..:l..~ Phone No . : li 1 0 l :>-E> ¥ -~ V /'I
----------------------·------------------~~ coupty: __ ~=5~~~·~~~·~t~~~r~~~----~--------­Far.n location : Latitude and Longitude: 7'? d.! ..!.!:, ·• 11.£" C7' L.£'' (required). Also .•
please attach a copy of a county road map with location identified.
Type of operation (swine, layer. dairy. etc.) =-""""='..--""'$"~i..:;::</:....:•~.::e_~---.,..-------
Design capacity (number of animals): 1 ),.£q f7<,_·~ fe r,...,., fi; ~~ ....
Average size of operation· (12 month population avg.) : /;;><.-o s.·.,.f:t·
Average acreage needed for land application of waste (acres) 1 ,:2 'f. S:
•==•••••••••••••••••••=~••••••••••••••••••••=••••••••••••••••z=•••••a•••=•••••
T•e~ieal Spaciali•t Carti~ieatic:
As a technical specialist designated by the North Carolina Soil and Water
Conservation Commission pursuant to lSA NCAC 6F .0005, I certify that the new or
~anded animal waste management system as installed for the farm named above
has an animal waste management plan that meets the design, construction,
operation and maintenance standards and specifications of the Division of
Environmental Manage.>nent and the USDA-Soil Conservation Service and/or the North
Carolina Soil and Water Conservation Commission pursuant to lSA NCAC 2H.02l7 and
lSA NCAC 6F .0001-.0005. The following e~ements and the i r corresponding minimum
criteria ·ha~een_verified by me or other designated technical specialists and
are included in the plan as applicable: minimum separations (buffers); liners or
equivalent for lagoons or waste storage ponds; waste s~orage capacity; adequate
quantity and amount of land for waste utilization (or use of third party); access
or ownership of proper waste application equipment; schedule for timing of
applications; application rates; loading rates; and the control of the discharge
of pollutants from stormwater runoff events less severe than the 25-yea.r, 24-hour
storm.
llama of' T•e~i ea l Sp•e ial.i•t ( p 1 ease Print ) ! ___ c=")-u;;.;_r__;f-.-.:...,-=· .S::..__B="-::....;:C!;.:,., ...;..r_...;.w.:__;;...;·c:.=·:...L.;:~::;:_ __ _
Affiliation: C .. • t..5 c'r G c o)
Address (Agency): .P r1 t!.·-.f:O Q (l i dfh f.IC ).~ny Phone No . O J ,. $"31'..1 -11 ,lib
signature :---+-C-=·,~d"""-a::::...:-::;_:?6::-::::;:. ·.....,;....--=&;,;;j. =:::.r.--;:0::::..::::~==-· _____ _ Date=-~/.. .... -......:../..::: . .S;_---_..._r .... );:-__
•===•••••••••c=••••••••••••••••••••••••••••3•••~••••••••••••••••••••••
~er/Hanager A~eamant
I (we ) understand the operation and main tenance procedu res established in the
approved animal waste manag-ement plan for the fann named above and will implement
these procedures . I (we) know that any additional expansion to the existing
design capacity of the was~e trea~ent and storage system or con struction of new
facilities will require a new certification to be submitted to the Division of
Environmental Manage.TDent before the new animals are stocked. I (we) also
understand that there must be no discharge of animal waste from this system to
surface waters of the state e i ther through a man-made conv e y ance or through
runoff from a storm event less severe than the 25-yea.r, 24-hour storm. The
approved plan w i ll be filed at the farm and at the office of the local Soil and
Water Conservation District.
S i gnature
~: Ac
(if the pproved
Envi ronmental
1~-A~
Date: k //tp / 2 £
,..;-7 I
(Please print): J '?SO /J ~·A/c../q /r
Date :-~~/:~1~6'----1-/~~:;...._...-­
ship requires notification or a ~w certification
is changed) to be submitted to the Division of
within 60 days of a title transfer. DEM USE ONLY:ACNEW# _________________ _
JO/ # .fr) ...... C(,'.._h"'.
f'" K.et'1.er. fv...~"' fe-f~-~ .... -1-o
6"-t> . All' ,-a )r . if. S ~ , /~ 5
/(eel'\e.r RJ J c> ""~x-.
3 ~:I~~~ ~ ........ ~"' r.yl,r. ... ..
,• II
I . .-.~
•