820625_INSPECTIONS_20171231

NORTH CAROLINA
Qepartment of Environmental Quality
Compliance lnspection
Reason for Visit: e Routine 0 Complaint
Structure Evaluation
0 Referral 0 Emergency 0 Other
Date of Visit: I '}/31pt I Arrival Timed J:J.!atpo I Departure Time:! 01.'¥ I County: ?-f'fD;"t
Farm Name: P lt/1 /.y; W J'( { t'Ctl'k_s &~"'1!1 Owner Email:
, I
Owner Name: Ph,'/(. f LJ ~-~ {r'C( n.< Phone:
Mailing Address:
Physical Address:
Facility Contact: ()o t'\&\. +i C4. flt 1/~Y Title:
Onsite Representative:
Certified Ope rator: pg.fn'ck= t,J .-l/ ,'tt...,.1
Back-up Operator:
Loca tion of Farm: Latitude:
Discharges and Stream Impacts
1. Is any disc harge observed from any part of the operation?
Discharge originated at : 0 Structure 0 Application Field
a . Wa s the conveyance man-made?
0 Other:
b . Did the discharge reach waters of the State? (If yes, notify DWR)
c . What is the estimate d volume that reac hed waters of the State (gallons)?
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
DYes ~No
DYes DNo
DYes 0No
d . Does the discharge bypas s the waste management system ? (If yes, notify DWR) 0 Yes DNo
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any obs ervab le adverse impacts or potential adverse impacts to the waters
of the State other than from a di scharge?
Page 1 of3
0 Yes 'fJNo
DYes DNo
'fJ
Region: J=P-o
DNA ONE
~NA ONE
ijQl NA ONE
~NA ONE
DNA ONE
DNA O NE
11411015 Continued
,IFacili!jo Number: I Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
DYes 0No ~NA ONE
Structure 5 Structure 6
0 Yes ~No 0 NA 0 NE
0 Yes ~No 0 NA 0 NE
If any of questions~ 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 ~No DNA ONE
0 Yes _,i] No DNA ONE
0 Yes i!J No DNA ONE
DYes ~No DNA ONE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes lg No DNA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > I 0% or I 0 lbs. 0 Total Phosphorus
0 Outside of Acceptable Crop Window
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
I 9. 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 0Checklists 0 Design 0 Maps 0 Lease Agreements
DYes ~No
DYes ~No
0 Yes ~No
DYes q9No
0 Yes lkJ No
0 Yes '?9 No
0 Yes ~No
Oother:
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~ No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Tr.lnsfers 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 facility fail to install and maintain a rain gauge? D Yes ~N o 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No 0 NA 0 NE
Page 2 of 3 21412015 Continued
Number: I Date of lnspedion: 1.j3i) g
'III.&JIUA'l'l:' waste application equipment as required by the permit?
25. Is the facility out of compliance with permit cond itions related to sludge? If yes, check
the appropriate box(es) below.
DYes ~No 0NA ONE
0 Yes}ij No 0 NA 0 NE
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge level s
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail p rovide documentation of an actively certified operator in charge?
27. Did the faci lity 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 facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e ., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
0 Yes If) No DNA ONE
0 Yes £f'No DNA ONE
0 Yes ·~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No ONE
Phone:
Date:
tj/od)J-55 LJO
7/~;/1!
I
2/4/1015
Operation Review 0 Structure Evaluation
Reason for Visit: e Routine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I q /tfrt Arrival Time: I Jt ;9J, .. ,....j Departure Time: 112 : ~o-J ~unty: ~ Region: fiJn
I ' Vf v
Farm Name: (J 4,7(:V1 4J /tl/1 ~ ~ ~k Owner Email:
Owne< Nam" fb '~~~ M Jtq.., z_ Pbon<'
Mailing Address:
Physical Address:
Facility Contact: ~"'-~ c../t...A-"4 ,lA f I~ Title: ----------------~~~~~---u
Onsite Representative:
Certified Operator: f~Jhc!L
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field
a. Was the conveyance man-made?
0 Other:
b. Did th e di sc harge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: ~J~
Certification Number:
Certification Number:
Longitude:
0 Yes ¥No
DYes 0No
D Yes 0No
d. Does the di sc harge bypass the waste mana ge ment system? (If yes , notify DWR) 0 Yes 0No
2. Is there evidence of a past discharge from any part of the operation?
3. Were th ere any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
0 Yes ~No
0 Yes ~No
DNA ONE
~NA ONE
{BNA ONE
iaNA ONE
DNA ONE
DNA ONE
11412015 Continued
IP'ilcility Number: I Date of Inspection:
I 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 Structure2 Structure 3 Structure 4
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
DYes D No !¥1'NA D NE
Structure 5 Structure 6
DYes ~No DNA ONE
D Yes ~ No D NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the 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
DYes
DYes
qlNo DNA ONE
IS'QNo DNA ONE
~No DNA ONE
~No DNA ONE
11. Is there evidence of incorrect land application? If yes, ch ec ~ the appropriate box below. D Yes ~ No 0 NA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN > 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area /) /\
12CropTyp•(s) O,.s/.J{ ~C).,<;; {J/4r 1 ~~) ~· C!--L914~, {;:~(~
13. Soil Type(s): /lk/l 1 c;(l] !&
14. Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
OwuP Dchecklists 0 Design D Maps D Lease Agreements
DYes
DYes
DYes
DYes
DYes
DYes
DYes
00ther:
l?9 No
~No
~No
~No
pNo
cg No
~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21. Does record keeping need improvement? lfyes, check the appropriate box below. DYes ~N o DNA 0 NE
D Waste Application D Weekly Freeboard D Waste Analysi s D Soil Analysi s D Waste Transfers 0 Weather Code
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? D Yes m No D NA 0 NE
23 . If sel ected, did the facility fail to install and maintain rainbreakers on irrigation equipment? D Yes ~N o 0 NA 0 NE
Page 2 of 3 21412015 Contin ued
!Facility Number: I 7 I Date of Inspection: 'f./ 't/f
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes ~No
0 Yes ~No
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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, fTeeboard problems, over-application)
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes ~No 0 NA 0 NE
DYes ~No DNA ONE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
DYes
DYes
DYes
~No
I;BNo
fgNo
DNA ONE
DNA ONE
DNA ONE
Comments (refer to question #): Eiplain any YES answers and/or any additional recommendations or any other comments.
Use drawings offacility to be~er explain situations (use additional pages as necessary).
Revi ewe r/Inspector Name: Phone:
Reviewer/Inspector Signature: Date: -------------------
Page3 of3 214!2011
/..../
Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Region:
Farm Name:
Owner Name:
Mailing Address:
PhysicalAddress: --------~------~~r..---------------------------------------------------------------
rn.. .II ,._ Jl~ cp/).
Facility Contact: __ a __ v __ ~---''-l-1---"'--""---------!.(j_vv _____ Title:---------------Phone: • ~
Onsite Representative: Integrator: ---lgi.i-=-'NJ=--~ey_ ......... -.9~--------r~~u~ {,;J;i;f,\~ Certification Number: ---+/___.9L.....::....?lfoq.L----
Certification Number:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
LIs any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field
a. Was the conveyance man-made?
D Other:
b. Did the discharge reach waters of the State? (Ifyes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2.ls 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
Longitude:
DYes ~No DNA ONE
DYes 0No ~NA ONE
DYes 0No ~NA ONE
DYes 0No ~NA ONE
DYes ~No DNA ONE
DYes No DNA ONE
214/ZOJI Continued
!Facility Number: IDate of Inspection: zv/td;;; J ,
Waste C'Oilectlon & Treatment
4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a . If yes, is waste level into the struc tural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: I
Spillway'?:
Designed Freeboard (in):
Observed Free board (in):
5. Are there any inunediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes cyflNo 0 NA D NE
0 Yes 0 No ¥1 NA D NE
Structure 5 Structure 6
0 Ye s 9}JNo 0 NA 0 NE
\
0 Yes rp 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
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
12 . Crop Type(s):
13 . Soil Type(s):
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?
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.
0 Yes ~No DNA ONE
0 Yes ~No DNA ONE
0 Yes rpNo DNA ONE
0 Yes rENo DNA ONE
DNA ONE
0 Yes tpJ No DNA ONE
0 Yes ~No DNA ONE
0 Yes 9No DNA ONE
DYes ~No DNA ONE
0 Yes ¥J No DNA ONE
0 Yes ~No DNA ONE
O Yes No DNA ONE
0WUP Ochecklists 0Design 0 Maps 0 Lease Agreements 00the r : _________ _
21. Does record keeping need improvement? Ifyes , check the appropriate box below. D Yes t"p No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0Weather Code
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall In spectio ns 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? O Yes ~No 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~ No 0 NA 0 NE
Page 2 of3 21411015 Continued
=-~~~--~~~~~~/~ I I I Facility Number: ~'J< i?z;} I I Date oflnspection: f{5 f j~
,24. ~id~he facility fail to calibrate waste application equipment as required by the penni; ( 0 Yes )?11 No DNA 0 NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes Q'1 No DNA 0 NE
the appropriate box(es) below.
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant s ludge levels in any lagoon
List s tructure(s) and date offrnt 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 orCA WMP?
33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
0 Yes ~No
DYes i1No
DYes 9PNo
0 Yes ~No
0 Yes ~No
DYes [6No
0 Yes ~No
0 Yes "Q!J No
DYes $No
DNA
DNA
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 of facility to better explain situations (use additional pages as necessary).
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/lnspector Name: Phone: q /V--j;J--"3 J OV
Reviewer/Inspector Signature: Date: /Ot~/; b
Page3 of3 11411015
Operation Review 0 Structure Evaluation
Reason for Visit: e Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Denied Access
Date of Visit: I "Nt s' I Arrivai_Time:IJ f) :oOa:: I Departure Time:ll, :~ I County: s~~N Region: Ef2o
Farm Name: {J kl{jp tJ //{/a_,._..., S Owner Email:
Owner Name: PM f,~ W r. { [ (4v--.._s Phone:
I
Mailing Address:
Physical Address: -----+-------------------------------------
9()'\A fVt) L Title: Phone: Facility Contact:
-~----~-~----~---------------
Oosite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
L Is any discharge observed from any part of the operation?
Discharge origi nated at: 0 Structure 0 Application Field
a. Was the conveyance man-made?
0 Other:
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volwne that reached waters of the State (gallons)?
Integrator: ?f'(s-fr<C)<.
Certification ~umber: _i~..-9..LJJ..f.¥~,r;.t...__ ____ _
Certification Number:
Longitude:
DYes ~No DNA ONE
DYes ONo ffi NA ONE
DYes 0No (lJNA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No ftl NA ONE
2. Is there evidence of a past discharge from any part of the operation?
3 . Were th ere any obs erva ble adverse impacts or potenti al adverse impacts to the waters
of th e State other than from a discharge?
Page I of3
DYes ~No
DYes ~No
DNA ONE
DNA ONE
214/1014 Continued
iFacilitY Number: loate of Inspection: w6 ....
Waste Collection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No
DYes 0No
DNA
-~NA
StructureS Structure6
ONE
ONE
D Yes rn No D NA D NE
D Yes re 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
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ltJ No DNA ONE
DYes ~No DNA ONE
DYes tfJ No DNA ONE
DYes E£lNo DNA ONE
11. Is there evidence of incorrect land application? Ifyes, check the appropriate box be low. D Yes '¥No DNA D NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN D PAN> 10% or 10 Ibs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window ind Drift
12 . Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does th e receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate ofCoverage & Permit readily available?
20. Does the fa cili ty fail to have all compo nents of the CA WMP readily available? If yes, check
the appropriate box.
0WUP D checklists D Desi l:,'ll 0 Maps 0 Lease Agreements
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes !fJ No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
00ther:
21. Does record k eeping need improvement? If yes, check the appropriate box below. 0 Yes ~No D NA 0 NE
D Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and I" Rai nfall Inspections 0 Sludge Survey
22. Did the facility fail to in stall and maintain a rain gauge? 0 Yes ~No 0 NA 0 NE
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~No 0 NA 0 NE
Page2of3 21412014 Co ntinued
5
I ' !Facility Number: I nate of Inspection:
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.
t·
DYes ¥iJ No
DYes '¥l No
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date offU"St 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 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? DYes
34. Does the facility require a follow-up visit by the same agency? DYes
~No DNA
lij No DNA
~No DNA
[BNo DNA
IXJ No DNA
~No DNA
~No DNA
[ENo DNA
I$J No DNA
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 n~sary).
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/Inspector Name: Phone: '1 /D -tfJ3-3 ~ tJO
Reviewer/Inspector Stgnature. Date . _&=-l-IJ;-1+).2L:.......-__ _
Page3of3 214/2014
Reason for Visit:
Date of Visit:
Owner Name:
Mailing Address:
ompliance Inspection
~outine 0 Complaint
Operation Review 0 Structure Evaluation 0 Technical Assistance
0 FoUow·up 0 Referral 0 Emergenc 0 Other 0 Denied Access
Departure Time: I /!fa t) I County: 5/ft(.. Regio :
Owner Email:
Phone:
Physical Address: ______ ............ -r--........ ----,---------.................................... --................................ --........................ --~ o~·!J{;; \L( ,Lfr(~itle: ______ _ Facility Contact:
Onsite Representative:
Certified Operator:
Back·up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field D Other:
a. Was the conveyance man-made?
b. Did the discharge re ac h waters of the State? (If yes , notifY DWQ)
c. What is the estimated vo lume that reached waters of the State (ga llons)?
Phone:
Integrator: e ( t".':i ~
Certification Number: f).:J 0 ~ T
ertification Number: l1i&6
Longitude:
DY es~ DNA ONE
DYes 0No ~-ONE
DYes 0No ~A ONE
(
d. Does the di scharge bypass the waste management system? (If yes, notify DWQ) DYes 0 No ~NA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes
DYes ~: DNA ONE
DNA ONE
21411011 Continued
[Date ollnspection: J f{;_ h(;l({ ¥ !Facility Number:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm s torage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5 . Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~NA O N E
DYes DNo ~ QNE
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 pit s, dry stacks, and/or wet stacks)
9. Does any part of th e waste management system other than the waste stru ctures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes g..N0 0 NA 0 NE
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~ D NA ONE
11. Is there evidence of incorrect land application? If yes, check the appropriate box bel ow. DYes ~ 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Me tals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to In corporate Manure/S ludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind D rift D Application O utside of Approved Area
12 . Crop Type(s): rp cJ'~ 1 f:;,5(!.{t ·€_
13 . Soil Type(s): i{o tr--Gz 12 f ~ 1lt-S
14. Do the receiving crops differ from those designated in the CA WMP?
15 . Does the receiving crop and/or land application sit e 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 properl y operating waste application equipment?
Required Records & Documents
19 . Did the facility fail to have the Cenificate o f Coverage & Permit readily availabl e?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
DYes
DYes
0 Yes
DYes
DYes
DYes
D Yes
~0 DNA
C1' DNA
~ DNA
@'No DNA
~0 DNA
~0 DNA
Q.blo DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
0WUP 0Checklists 0 Desi~:,'ll D Maps D Lease Agreements 00ther: _________ _
21. Does record keeping n eed improvement? l fyes, check the appropri ate box below. 0 Yes Q-No D N A 0 NE
0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis D Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspectio~1 s 0 Sludge Survey
22. Did the facility fail to in sta ll and maintain a rain gauge? D Yes o 0 NA 0 NE
I
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes No DNA 0 NE
Page 1 of3 11411011 Continued
Number: I Date of Inspection: {1{c f] • ' r ~ 't~
waste application equipment as required by the permit? 0 Yes ~ NA 0 NE
25. Is the facility out of compliance with permit conditions related to sludge? Ifyes, check 0 Yes ~ NA 0 NE
the appropriate box(es) below.
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.
DYes
DYes
0 Yes
0 Yes
DYes
DYes
0 Application Field D Lagoon/Storage Pond D Other: ------------------------
32. Were any additional problems noted which cause non-compliance ofthe permit orCA WMP? 0 Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes
34. Does the facility require a follow-up visit by the same agency? DYes
~DNA
~DNA
~DNA
~DNA
~DNA
~DNA
~DNA
~DNA
No DNA
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).
&(;b~Q~
sl~J.;e Sa~
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of3 11412011
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Operation Review
0 Fol 0 Referral 0 E 0 Other
DateofVish: ~ Arrival Time:~ Departure Time:~ County: 5'AA.
Farm Name: ~({Jr.{/~<;.,_.( Owner Email: -------------
Own.rName: '~L(( .~ (y V\_£r.J/ Phone:
Mailing Address:
Physical Address: -------:----------:--------:~----------------------,~~ yyfc) 13 NW c C/t;;itle: _-_r_-_ve __ _ Facility Contact:
Onsite Representative: -----~-------;----------
~ (ty,_ -r't'".dvt'tl Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Di sc harge 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 that reached waters of the State (gallons)?
Pbpone~ //~, .
Integrator: _L _ ___;f:..._ ~-..l.L.~f9:!~------
Certification Number: ._[__.:......!...:{ .2~:....0 _____ _
Certification Number:
Longitude:
DYes EJ"'No DNA ONE
DYes 0No ~ ONE
DYes 0No 01JA 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 ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes ~
DYes ~
DNA ONE
DNA ONE
21412011 Continued
I Facility Number:
Waste Collection & Treatment
loate of Inspection: I{) ~,c/ qi r r
'4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a . If yes, is waste level into th e structural freeboard?
Structure 1 Structure2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 61
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 0No c;;JNA ONE
StructureS Structure 6
D Yes ~NA ONE
DYes ~NA ONE
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 structures lack adequate markers as required by the permit?
(not applicable to roofed p its, dry stacks, and/or wet stacks)
9 . Does any part of th e waste management system other than the waste structures require
mainte nance or improvement?
Waste Application
10 . Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or i~provement?
D Yes (21-Ntr D NA D NE
D Yes []-"N<> D NA D NE
DYes ~DNA ONE
DYes ~DNA ONE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes [}.blo-DNA D NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metal s (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 Cro p Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12 . Crop Type(s): 0tJ 'vx~d: 8 G 12
n . Soil Type(s): .1) 0 ttA~rvv t1 -
14. Do the receiving crops differ from those J~ignated in theCA WMP?
15. Does the rec eiving crop and/or land application site need improvement?
16. Did the facility fail to s ecure 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 prope rly operating waste application eq uipm ent?
Required Records & Documents
19 . Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the fa ci lity fail to have a ll components of the CA WMP readily available'! If yes, check
the appropriate box .
QWUP Ochecklists 0Design 0 Maps 0 Lease Agreements
DYes
DYes
~DNA
~DNA ONE
D Yes [Z}1<fo
0 Yes c:::;;rNo
0 Yes (JJ..N o
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21. Does rec ord keeping need improvement? If yes, check the appropriate box below. 0 NA D NE
D Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analys is D Waste Transfers 0 Weather Code
D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall In spections 0 Sludge Survey
22 . Did the facility fail to install and maintain a rain gauge? 0 Yes [Jj"No 0 NA 0 NE
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~No 0 NA 0 NE
Page2of3 214/2011 Continued
!Facility Number: lnate of Inspection: /b A~ f{
,24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes
DYes
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? DYes
27. Did the facility fail to secure a phosphorus Joss assessments (PLAT) certification? DYes
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? DYes
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes
D Application Field D Lagoon/Storage Pond D Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes
34. Does the facility require a follow-up visit by the same agency? DYes
~NA
~EJNA
g<o DNA
~ DNA
~· DNA
~ DNA
~DNA
~DNA
[;FNo DNA
~0 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).
Reviewer/Inspector Name :
Reviewer/Inspector Signature:
Page3 of3
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Operation Review Technical Assistance
Reason for Visit: ®'Routine 0 0 0 Referral 0 l<:n•Pr'oP•u·v 0 Other 0 Denied Access
Date of Visit: JSGi/ 2«lrival Time: I[/: 1 D Departure Time:tff~ ro I County&;:;.....«..;.::.'¥''1""'---Region{12r)
Farm Name:_-4f~h....:......:...t{~~ ...... (...,.{J"'------""lJ:::lll!~( •a..:((..Lt..w:ct_~ ___ f!=~....:::u_"""-_ Owner Email:
fk.lf~ 1\ w t oc.~ v , Owner Name: Phone:
Mailing Address:
Physical Address: --------=------:r---------------------------------~~~~ "*'~.~~..::....!....l\\.~1Ip._k_ritle: 1t-~ Facility Contact:
Onsite Representative: .{.
Certified Operator: ft..e 1.\: ~ w . I l,( l' ,_ V'-r
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field
a. Was the conveyance man-made?
D Other:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Intog•ato" Prt r/e..z, _.,.
Certification Number: ~0¥ '7
Certification Number:
Longitude:
DYes~ DNA ONE
DYes [::!No ~A ONE
DYes 0No ~ 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 ofthe 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
DYes
~ DNA ONE
~ DNA ONE
214/2011 Continued
I Facility Number: I Date of [ospection~~clo fJ 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 freeboa rd?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): ( 1
Observed Freeboard (in): ~ 1
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees , severe erosion, seepage, etc.)
6 . Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~DNA ONE
DYes~ DNA ONE
StructureS Structure 6
DYes~ DNA ONE
0 Yes QX<} 0 NA 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 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 improve ment?
Waste Application
10 . Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes GJ-X6 0 NA 0 NE
D Yes [!I.-NO 0 NA 0 NE
DYes ~o DNA ONE
11. Is there evidence of in correct land a pplication? If yes, check the appropriate box below. DYes ~ 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metal s (Cu, Zn, etc.)
D PAN D PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Fa ilure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acc eptab le C rop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12 . Crop Type(s ): gC/~'C
13. Soil Type(s): G () \2-.J*
;.. f~..fCA.,...A.
fDfi
14. Do the receiving crops differ fro m those designated in theCA WMP?
15. Does the receiving crop and/or land application si te 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 ac reage for land application ?
18. Is there a la ck of properly operating waste application equipment?
Required Records & Docume nts
19 . Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have a ll components of theCA WMP readily avai lable? If yes, check
the appropriate box.
DYes ~ DNA
DYes [i.XO DNA
DYes [JAW DNA
DYes ~0 DNA
0 Yes [B-'No DNA
DYes ~0 DNA
DYes ~ DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
DOther: /
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes [!('No 0 NA 0 NE
OwVP O c heckl ists 0 Design 0 Maps 0 Le ase Agreements
0 W aste Application 0 Weekly Freeboard 0 Waste Analysi s 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0Stocking 0 Crop Yield 0120 Minute Inspection s 0 Monthl y and I" Rainfall Inspections _/OSludge Survey
22. Did the facility fail to in stall and maintain a rain gauge? D Yes r::1' No . 0 NA 0 NE
23 . If se lected, did th e faci li ty fail to install and maintain rainbreakers on irrigation equipm ent? D Yes ~ 0 NA 0 NE
Page 1 of3 214/1011 Continued
!Faclli; Number: ~ /:J15 I I Date off••!!!<•••' J:SVJf 13-1 ~ 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes DNA
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes ~ DNA
the appropriate box(es) below.
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? DYes ~ DNA
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? 0 Yes ~0 DNA
Other Issues ~ 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes DNA
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? D Yes ~0 DNA
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 D Yes ~ DNA
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 DNA
0 Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes [B'No DNA
33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representati ve? DYes ~ DNA
34. Does the facility require a follow-up visit by the same agency? DYes ~QNA
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 pa es as necessary).
&\~M-~_,_ f' J-~-l3
s\J-<-s""'"~ 8':"-J-f~ t5
Reviewer/Inspector Name:
Re v iewer/Inspector Sign ature :
Page 3 of3
6-l-(, 0
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ompliance Inspection Operation Review 0 Structure Evaluation
Reason for Visit: ~outioe 0 Complaint 0 Follow-up 0 Referral 0 Emergency
Date of Visit: 15}!sjtJ. I Arrival Timed\\: 45 l'\JV) I Departure Timed \6'.4.) pI County:~ntrt p50n Region:(~
Farm Name: \) \u. \\,j \) \.)~\be'«!'!> fA {t""' Owner Email:
OwnerName: \?Yu:.\\r9 w~\\'l-AN Phone:
Mailing Address:
Physical Address: ---------------------------------------------------------------------------------------
Facility Contact:
Onsite Representative: _,S"""'-'A'-'-'-fN,...;...;:,.,_ _____________ ..:._ ______________ _
Certified Operator: ?e~fo c.K '1> _ ll:.1 \\1._ Am-5
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: 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)?
Phone:
lntegrator;7R £5~ f
Certification Number:
Certification Number:
Longitude:
0 Yes [)J"No
DYes 0No
DYes 0No
DNA ONE
fitNA ONE
~NA ONE
d. Does the discharge bypass the waste management system? (lfyes, notify DWQ) 0 Yes 0No ~NA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Pagel of3
0 Yes
0 Yes
GJ'No DNA ONE
~No DNA ONE
2/4/2011 Continued
lnate oflnspedion: shs »;)
r s
!Facility Number:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in): \9
Observed Freeboard (in): ~\
5. Are there any immediate threats to the integrity of any ofthe 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 [3;tNo DNA D NE
DYes 0No gNA ONE
Structure 5 Structure 6
DYes [g'No DNA D NE
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 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 GJI"No
DYes §'No
DYes 0No
DNA ONE
DNA ONE
DNA ONE
DYes 5t'No DNA D NE
II. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. DYes [9"'No DNA 0 NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Type(s): ~~\\TC\ U{)~ (_ \-\~'h.\>1\.s-\u~J } £ .G .Q • f f..&C...u£.. lGf.l..'f\7-C..,)
13. Soil Type(s): f o A\ [-?o Jl 1 ({Aft
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
OwuP Ochecklists 0Design 0 Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes ~0 DNA ONE
DYes (i}No DNA ONE
DYes g'No DNA ONE
DYes g'No DNA ONE
DYes !!(No DNA ONE
DYes g'No DNA ONE
DYes [g'No DNA ONE
Oother:
DYes lla'No DNA ONE
D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Weather Code
D Rainfall D Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
Pagel ofJ
0 Yes (g'No
0 Yes 0 No
DNA ONE
(]i"NA 0 NE
114/2011 Continued
..•
I Facility Number: iS'd. -lp';).5 !Date of Inspection: Sfls/~
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes ~No 0 NA 0 NE
0 Yes ~No 0 NA ONE
0 Failure to complete annual sludge survey 0 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 to provide documentation of an actively certified operator in charge?
27 . Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29 . At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge , freeboard problems, over-application)
31 . Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
DYes E1'No DNA ONE
DYes 0No DNA ~E
DYes [;?'No DNA ONE
DYes g'No DNA ONE
DYes l7No DNA ONE
DYes liZf No DNA ONE
0 Application Field 0 Lagoon/Storage Pond 0 Other: -----------------------
32 . Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34 . Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Revi ewe r/I nspector Signature:
Page3of3
DYes MNo DNA ONE
DYes l\JNo DNA ONE
0 Yes GlfNo DNA ONE
Phone : ~\(Y~-l-2~1
Date: S hS'' \!)
214/1011
ompliance Inspection Operation Review 0 Structure Evaluation
Reason for Visit: @1(c)utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Denied Access
Date of Visit: Arrival Time:j g~ Departure Time: I/ )a:2 I County:~ Region: Ek/\
,f'~
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: -------------------------------------------
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure D 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)?
Phone:
Integrator: _..JJ),ur-e~.::=....--S.;a.¥..!..:::=J~r-=:...._------
Certification Number: /qff~
Certification Number:
Longitude:
DYes~ DNA ONE
DYes 0No ~A ONE
DYes 0No ~ 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 I of3
DYes
DYes
~0 DNA ONE
~DNA ONE
214!201J Continued
JFaciHty Number: I Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity {structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: #I
Spillway?:
Designed Freeboard (in): •
Observed Freeboard (in): Js-
5. Are there any immediate threats to the integrity of any of the structures observed?
(i .e ., large trees, severe erosion, seepage, etc.)
6 . Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~o
DYes 0No
DNA ONE
(B1CTA D NE
Structure 5 Structure 6
DYes ~o DNA ONE
DYes~ DNA ONE
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 structures lack adequate markers as required by the pennit?
(not applicable to roofed pits , dry stacks, and/or wet stacks)
DYes~
DYes ~o
DNA ONE
DNA ONE
9. Does any part of the waste management system other than the waste structu res require
maintenance or improvement?
DYes~ DNA ONE
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes
I I . Is there evidence of incorrect land application? If yes, check the appropriate box below . 0 Yes
DNA ONE
DNA ONE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc .)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Applicat ion Outside of Approved Area \
12 . Cmp Type(s)o }xn~r. ( t:.t -aLr:e· u.sk~) j $Go ' ~~ (~) ~A :C' . . I I
13 . Soil T ype(s): rt>r+-~
14 . Do the receiving crops differ from those designated in the CAWMP? 0 Yes ~ DNA 0 NE
I 5 . Does the receiving crop and/or land application site need improvement?
I 6. 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 properl y operating waste appl ication equipment?
Required Records & Documents
I 9 . 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 .
Dwup Ochecklists 0 Design D Maps D Lease Agreements
DYes
DYes
DYes
DYes
DYes
DYes
00ther:
ia1fo D NA ONE
rJ1<fo DNA ONE
~ DNA ONE
~ DNA ONE
~ DNA ONE
~DNA ONE
21. Does record keeping need impro ve ment? If yes, check the appropriate box below. DYes ~ DNA 0 NE
0 Waste Application 0 Weekl y Freeboard D Waste Analysis D Soil Anal ysis 0 Waste Trans fers D Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I " Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~o DNA 0 NE
23. If se lected, did the facility fail to install and maintain rainbreakers on irrigation equipmen t? DYes D No ~A 0 N:E
Page 1 of3 21411011 Continued
I z [Facility N,umber: 2b1, · ~ I nate of Inspection: IJI tk f 7 I
24C o;d tl,, fac;I;ty fail to cai;brnte w"te appl;<ation equ;pment " reqWred by the penn;: r D yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes
D Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structurc(s) and date offJISt survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? DYes
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? DYes
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes
0 Application Field 0 Lagoon/Storage Pond D Other: , ____________________ __
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes
34. Does the facility require a follow-up visit by the same agency? DYes
DNA ONE
DNA ONE
[i?o""-D NA ONE ~ 0No DNA
ffNo DNA ONE
~ DNA ONE
(U..HO DNA ONE
~0 DNA ONE
~ DNA ONE
[g-1(o DNA ONE
rn/o DNA ONE
Comments (refer to question #): Explain any YES answer-S and/or any additional recommendations or any other comments.
Use drawings offadlity to better explain situations (use additional pages as necessary).
~ ~ k.-~ oj-31/Zct!.
~ fi:~ ~ ~cLq----
Reviewer/Inspector Name:----T ~~ -+-!.~~~( u 1:::J
Reviewer/Inspector Sign~C!r~e~:..._--~~~· f !e!!::&~::::::l~~t..\~f~~~I(I:~"I..<~~~-----...,..------------
Page3of3 cr-U
Phone: tf /0~3-J:ff}
Date: Jo/¥ZL>I/
?fmon
tp/Zf/2 olo
Compliance Inspection 0 Operation Review
Reason for Visit ~ine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Region: DateofVisit: 16-I;J--10 I ArrivaiTime:lt:oo~M I DepartureTime: !2:0'/M I County: $4¥5'"<~~'N"
Ph ()l'IJ tJi//, giH : n_vl-1 Owner Email: ------------/
Farm Name:
Owner Name: Pb; "'fJ wet/, --. • ...s _______ _ Phone:
Mailing Address: ------------------------------------____ _
Physical Address:--------------~,.---------------------------~ J/ r;-Mflc.-v · L
Facility Contact: U1 t:..N(J f(.~lf~..JatV~,_,., Title: led r~ · f C<Qts.,/4;1·--phoneNo: ---------
Onsite Representative: ~&Aj/,0 w Mt/0 Integrator: ----~.A~Y....:c::g~~....:..a~=::::~:;._ _______ _
/) .~t'<~r..-'\A-..5
Certified Operator: r"'ifkp 111/fkv___________ Operator Certification Number: --------
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: r-roD'D" Latitude: L.._J Longitude:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes ~o DNA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other
a. Was the conveyance man-made? DYes 0No Etl'fA ONE
b. Did the discharge reach waters of the State? (If yes, notifY DWQ) DYes 0No B"'NA ONE
c. What is the estimated volume that reached waters of the State (gallons)? I
d. Does 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 adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
DYes ~DNA ONE
DYes ~DNA ONE
12/28104 Continued
[!acility Number: 82-~251 Dateoflnspection l~-17-101
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plu s heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes ~DNA ONE
DYes ~ DNA ONE
Stru cture 5 Structure 6
Identifier: _....:.J..-=;a""'"_,q_l_ ------------------------_..;... ____ _
Spillway?: N 0
Designed Freeboard (in): __ ..,~l_'t.......,_.,........,,.....-------------------------------*2 il ,,
Observed Freeboard (in): ---2~....:7~-------------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, seve re erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste manageme nt 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 st ructures ne ed maintenance or improvement? DYes ~ DNA D NE
8. Do any of the stu cturcs 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/improve ment?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
DYes DNA ONE
DYes DNA ONE
DYes ~DNA ONE
DYes ~ DNA ONE
0 Excessive Ponding D Hydraulic Overload D Frozen Gro und D Heavy Metals (Cu, Zn , etc.)
D PAN D PAN> 10% or 10 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s) _,!:lS~e-:::.:"'"'-!M~~~:........!....!.!.:~~~~~,..........J..C.~~r;;~,..~;q!..!.,r..:!::tU:........!::..!(o~.=-=S:....·::::_)=-;-_h~;e:==&:;:::::::::~:..-<.::...._;_(~:::....:.Yz:t=o~'---
13. Soil type(s) DA
14 . Do the receiving crops differ from those designated in theCA WMP? DYes No DNA ONE
15 . Does the receiving crop and/or land application 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 0 0 NA D NE
17 . Docs the facility lack adequate acreage for land application? DYes ~DNA ONE
18. Is there a lack of properly operating waste application equipment? DYes No DNA ONE
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):
• 1-
-....
Reviewer/Inspector Name IR,~k ~~~vel~ I Phone: CfiO .'f33 33l>D
Reviewer/Inspector Signature: ~~h~~ Date: 6 -17-2010
Page 2 of 3 12128104 Contmued
. . .. I Facility Number: 82. -" Z5)
Required Records & Documents
Date oflnspection I ~-17 ·I 0 I
19 . Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes
DYes
~DNA
~DNA
ONE
ONE
DYes ~DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall D Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections D Weather Code
22 . Did the facility fail to install and maintain a rain gauge? DYes ~DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? D Yes ~DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~0NA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~ DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes ~ DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~DNA ONE
Other Issues
28. Were any addition al problems noted which cause non-compliance of the permit orCA WMP? DYes ~ DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes ~ 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 DNA ONE
If yes, contact a regional Air Quality representative immediately ~DNA 31. Did the facility fail to notify the regional office of emergency situations as required by D Yes ONE
General Permit? (ie/ discharge , freeboard problems , over application) ~DNA 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ONE
33 . Does facility require a follow-up visit by same agency? DYes [l31( DNA ONE
Page 3 of 3 11128104
11-IO -Z-tJIJ9
Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: l/1·10-0 'f I Arrival Timed I,' 3.J~ M. I Departure Time: l.:z ; 3 ~,., I County: S'"9A:tpS"O N Region: F/2.0
JP ~ ~
FarmName: Ph;llip w:tl!Q.M.S t-a..V)v1 OwnerEmail: -------------
Owner Name: Phi ll.'p Wj//,'4"'1.5 Phone:
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: _....;:G:..__~_N--'o::....._--'K;,_;,_;;~___;JJ_ed--=:':J-+----Title: __,l_t.;:;,;c;;;;;~;.:...:..• __;;,fFP...:::4=-=_.'"----Phone No: --------
Oosite Representative: To IJa. ~"-N M ,.,, ~ r Integrator: _....:...A....:...r..;;;(!.;.:S;;.,JA~~~~~<--=---=-~-==:..:....::~~----
Certified Operator: P"'-,'J lr' p W ~·If /o..~.,.;.:.~=-----------Operator Certification Number: -------
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD 'D" Longitude: D OD'D"
Discharges & Stream Impacts
I. Is any discharge observed from any pan of the operation? DYes Ef'N"o DNA D NE
Discharge originated at: D Structure 0 Application Field D Other
a. Was the conveyance man-made? DYes 0No E3'NA ONE
b. Did the discharge reach waters of the State? (If yes, notifY DWQ) DYes 0No ~A ONE
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) DYes 0No CB1'JA ONE
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 ~
DYes ~
12118104
DNA ONE
DNA ONE
Continued
jFacilityNumber: SZ.-6251 Date oflnspection jii'IO-o9l
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
DYes ~ DNA ONE
Structure 5 Structure 6
Identifier: ----"~-~~-~-~------------------------------------
Spillway?: N 0
Designed Freeboard (in): __ ..;.i_q.:..__ __ ------------______ ------------
Observed Freeboard (in): __ 3=-.;cO~--------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ic/large trees, severe erosion, seepage, etc.)
DYes ~ DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed DYes ~DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any ofthe structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
DYes ~ DNA ONE
DYes [31ro DNA ONE
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
0 Yes g.,<fo 0 NA 0 NE
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
0 Yes [31(o' DNA ONE
II. Is there evidence of incorrect application? If yes , check the appropriate box below. 0 Yes ~ DNA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12. Crop type(s) --=B=--.:::e..:...v..!..J-~~~~~_JG..._~!:.!=:J.... J-r....!' C~n;..;tJ~c<~)~7..----:S.::...kA:..:.:.::4.=:!{:.!.../...!:{;~~-=:..:.'w:.._:~~o:....:.'=s..;;');;;,1,_....:.h~e.==-s-..;:;..cu;..;...;:.c..__:....( <;..::.. _n_,l~..=(....:.....;J~--
13. Soil type(s) Go A . &.., Fo A
}
14. Do the receiving crops differ from those designated in the CAWMP? 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 B"'No D NA D NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly opcmting waste application equipment?
:r "'"'·)C. j. • .,__
l.-t:k:J'FO,.J St.A. ... \1.11
Ftud rH R,v
r:,·e. teL p H ~
Reviewer/Inspector Name
Reviewer/Inspector Signature:
do.v<..... z.oo9 !
2. DO 9 I
Pw L/ s~-w~d' 7. e
Pu.J 'I s t.~~d... I. 0
~ l. I
~ ,, z.
DYes []-No
DYes ~
oN //-3o-;uJ07
oN ; z. -o 8 -2oofl
DNA ONE
DNA ONE
Phone:
Date:
Cfl(), ~33' 330 0
11-10 -:2oo9
12128104 Continued
.. _ ....
I Facility Number: 82 _,251 Date oflnspection 111-10 -o9l
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other
0 Yes l31fo 0 NA 0 NE
0 Yes []1:/o 0 NA 0 NE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~ D NA D 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?
. 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 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 appli cation)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representati ve?
33. Does facility require a follow-up visit by same agency?
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~ DNA ONE
0 Yes cn:lo DNA ONE
DYes l31fo DNA ONE
DYes ~o DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes (31C(o' DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
12128104
Compliance Inspection 0 Operation Review
Reason for Visit ~ne 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 17-/7-081 Arrival Timed/.2 :5 ~,.,}Departure Time: lt:t:z~ ..,111 1 County: Sa."'V:s;;rJ
P r ~ ·I· I \' ll , r .-:-_ I
Region: ~/20
Farm Name: 11\1 ( I p W L WIN\.$ CU VJ.1.A.. Owner Email:--------------
Owner Name: p b j if j p W ll(t(t ~ Phone:
Mailing Address:
Physical Address: -::-----:--:------.------------..,-.---r,-~ --------------------
GuJo Ke...tNW:J ~-S",..........e...•
Facility Contact: Xm.Jo:..IAo.AJ /lA lllt.v Title: ------------Phone No:---------
Onsite Representative: -------------------Integrator: --....LP_.J..t:...lie..._S!...oc...+!.... a.=.-~F==:;:__ ____ _
Certified Operator:--------------------Operator Certification Number: --------
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm:
Design ---~"'-current
CapacitY ~-P~pulation
Latitude: D OD'D"
Design Current
Wet Poultry Capacity Population
Longitude: D OD'D"
/F-~~~~~~~-----+------~·r-[J~L_ay~e~r-----+------~1------~~-E:~~~----~----~r-----~ ~~~~~~~~-+---:--~----~· ~tJ~_N~o~n~-~L~a~ye~r~~---~----~-
Dry Poultry .
[]Layers
[]Non-Layers
[]Pullets
[]Turkeys
[] Turkey Poults
[]Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: [] Structure 0 Application Field 0 Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notifY DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
DYes ~ [JNA ONE
DYes 0No ffiiA ONE
DYes 0No D1M ONE --
DYes EfNo (]NA [JNE
DYes ~DNA [JNE
DYes ~ DNA ONE
11128104 Continued
I Facility Number: <gz -(p Z5l Date of Inspection 17-n~oa I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure4
Identifier: I
Spillway?:
DYes ~o DNA ONE
DYes ~DNA ONE
Structure 5 Structure 6
Designed Freeboard (in): ___ 1--'q'--------------------·--------------------
Observed Freeboard (in): ___ ¥{)...!......:~'-'_ ----------------------------------
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 ffio 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 buflers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~DNA ONE
DYes ~o DNA ONE
DYes l31'ro DNA D NE
DYes ~DNA ONE
II. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes ~ DNA D NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
D PAN D PAN> 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12. Crop type(s) ~ t.~!e..... ( ~ f'o.sfvrt..) .d.t (;'n>-;,... (o. S.
13. Soil type(s) Go A Ra. A Fe f\
) I
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
DYes ~DNA ONE
DYes ffio DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?D Yes ~DNA
~DNA
~DNA
ONE
ONE
ONE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
DYes
DYes
Co~ents (refer to question#): Exphiio any YES answers and/or any recommendations or any otber comments.
USe drawings of facility to 'better explain situations. (use additional pages as necessary):
~ . . . '
Reviewer/Inspector Name !Kic.~ ·-g~vLU Phone: q1o, '1-33, 3330
Reviewer/Inspector Signature: A.~ :L A;..~_.~L Date: z-/7-z..LJ£J e
Pagel of 3 11128104 Continued
.... -
-....
....
I Facility Number: cgz -62.51
Required Records & Documents
Date oflnspection ( 1 ~11-0 B I
19 . Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facil ity fail to have all components of the CA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps D Other
21 . Does record keeping need improvement? If yes, check the appropriate box below.
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysi s 0 Waste Transfers D Annual Certification
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspe ctions 0 Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23 . If selected , did the fac ility fail to install and maintain rainbreakers on irrigation equipment?
24 . D id 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 lssues
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 mortal ity rates that were high er than normal?
30. At the time of th e inspection did the facility pose an odor or air quality concern?
If yes , contact a regional Air Quality representative immediately
3 1. Did the facility fail to not ify the regional office of emergency situations as required by
General Permi t? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to di scuss review/inspection with an on-site representative?
33. Does facility require a follow-up vi sit by same agency?
Page3 of 3
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
12128104
l31"lo 0 NA ONE
~DNA ONE
~DNA ONE
~DNA ONE
~DNA ONE
~DNA ONE
~DNA ONE
~DNA ONE
~ DNA ONE
~ DNA ONE
~ DNA ONE
~ DNA ONE
. 'fd Div ision of W a ter Quality
IFacility Number~~?.-H eo~Sil 0 Di vision of Soil and Water C onservation
0 Other A gency
Type of Visit )) Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
I County :~"&)(\ Date of Visit : I b1-Arrival Time: 1/J tfO I Depa rture Tim e: I /(fO Region:
I ' Owner Ema il : -------------
Phone:
M a iling Address: ----------------------------------------
Physical Address :~------,,_.._--.....,....--------=....--------..,,....--...-~~.,.,.....,...,....,...,,....----------~ ft • _ V r'\n ~ •• j ===T:'"' n_ s~ ~ P., f IPtM fn 131 1-<f
F a cility Contact: '-dQ.f\Q 1"\e...t'\~ Title: \ Wl ~(_ Phone No : ---------
Ons;te Reprcsent•tive ' &no l<.wN J~ lnteg.ato" P R~
C ertified Operator: Operator C e rtification Number: -------
Ba ck-up Operator: --------------------Back-up Certification Number:
Loc a tion of l<'arm : Latitude: D OD 'D " Longitude: D OD'D "
Desig n C ur r ent De sign Current
_,·_.·-~
D esign C u rrent
Swin e C apacity Population Wet Poultry Capacity Po pulatio n Cattle C apacity Popula tion 10 Layer ID Wean to Finish
0 Wean to Feeder I i . 0 Non-Layer
0 Dairy Cow I
0 Dai ry Calf
~e d e r to Fin ish /./.InDO 'f(p(jJ 0 Dairy Heife1
0 Fa rrow to Wean
0 Farrow to Fee der
0 Fa rrow to Fin ish
0 Gi lt s
0 Boa rs
0 DryCow
0 Non -Da iry
0 Beef Stockel
0 Beef Feeder !
. 0 Beef Brood Cow i
".
I
Dry Poult ry
0 Layers
0 Non-Layers
0 P ull ets
0 Tu rkeys
Other 0 Turkey Poults
0 Ot her Number of Structures: []] lD Other
Discha rges & Strea m Impa cts
I . Js any discharge observed from any part o f the opemtion? D Yes ~No D NA O NE
Discharge originated at: 0 Structure 0 Application Field 0 Other
a. Was the con veyan ce man-made? DYes 0 No ~N A ONE
b. Did the disc harge reac h waters of the State ? (I f yes, no tify DWQ) D Yes 0 No ~A O NE
c. What is the estimate d volume th at reached wa ters of th e State (ga ll ons)? I
d . Docs discharge bypass t he waste management system? (If yes, not ifY DWQ)
2. Is there evi dence of a past disc harge from a ny part o f the ope ration?
3 . Were th ere any adverse impa cts or pot enti a l adverse imp acts to the Wa ters of th e State
other than from a di sc harge?
D Ye s 0 No M NA O NE
D Yes ~No D NA O NE
D Ye s 0 No ~NA O NE
11/18/04 Continued
I Facilily Number: V' -{p 'L5J Date of Inspection ,
Waste Collection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If ye s, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes ~No DNA 0 NE
DYes ~N o DNA ONE
Structure 5 Structure 6
Identifier:--~~>----------------------------------______ _
Spillway?:
Designed Freeboard (in): -----,=-\-8_._ ___ ----------------------------------
Observed Freeboard (in): _ ____::3-'1___;:...__ ------------------------------
5. Are there any immediate threats to the integri ty of any ofthe structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes "'~§.No 0 NA 0 NE
6. Arc there structures on-site which arc not properl y addressed and/or managed DYes ~N o 0 NA 0 NE
through a w a ste 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
I
7. Do any of the structures need maintenance or improvement? OYeJ_~No DNA ONE
8. Do any of the stuctures lack adequate markers as required by the pennit?
(Not applicable to roofed pits, dry stacks a nd/or wet stacks)
DYes '!JNo DNA 0 NE
9 . Docs any part of the waste management system other than the waste s tructures require
maintenance or improvement ?
DYes '¢.No 0 NA 0 NE
Waste Application
I 0. Arc there any required buffers, setbacks, or compliance alternatives that need
maintenance/improveme nt?
DYes ~No DNA ONE
ll. Is there evid ence of incorrect applicati o n ? If yes, check the appropriate box be low . .JifYes 0 No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Ove rload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN > 10% or 10 lbs 0 Total Phosphorus D Fai lure to In corporate Manure/Sludge into Bare Soil
0 Outside of Acceptabl e Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12 . Crop type(s) ___:::b=-::v rn~v..;~~:::::.:P.....l......-:~:...:.....__..Ji.__..:....P---+-_~.=....:..,,;__;G:::;..:::'\:..;_( _o(-=f. ..... ::....l<)_t--.......;~_.;.e;...:::.s....:::::c...u~e::;___G::...:....,Q...:..::tj~~------
G\ A 1 ~Q A 1 r~ A 13. Soil type(s)
14. Do the receiving crops differ from those designated in theCA WMP?
15 . Docs the receiving crop and/or land appli cation site need improve ment?
DYes
DYes
lSJNo
~N o
16. Did the facility fail to sec ure and/or operate per the irrigation design or wetta ble acre detennination?O Yes ~0
I 7 . Does the facility lack adequate acr eage for land application?
18 . I s th ere a lack of properly operating waste a pplication equ ipment?
DYes ~No
DYes ~No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings offacility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name
Reviewer/Inspector Sig natu re:
D NA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
..f Facility Number: <6'2 ~<;I Date of Inspection ~
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes , check
the appropirate box. D WUP D Checklists D nesign D Maps D Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes 3JNo DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification
D Rainfall 0 Stocking 0 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 ~No DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes 0No fKJNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes lSINo DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the pennit? DYes ~No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes ~No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 0 No J'LNA 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 )(J No DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes }.&.No DNA ONE
If yes, contact a regional Air Quality representative immediately
)a No 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) ~No 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 )O!No DNA ONE
Additional Comments 80(1/or Drawings:
®-Y' v..\\~ I --t t -L 6 I-]. t ~{U --\:, ~ "~"'(!(j'[;ULtp._ ba.s.J • 1-
<> h w.:._ "'b ~~ \>.k Qn<>..l~ . 1, f"'<>V 1 J... i "-f ""'-+i q..._
:::: ~ 1nJ 0.. (.lUJ>-~ ""'"' --\ ~ :, • ~
_I "-\5> r ""-'-l:vv-~ 'a. S "'-b"' ~ +-l.:..ed \,() I { I '5/ oY, ·
-•
12/28104
35.251044N 78.40554IW-Google Maps .
.~~
I
I
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f
I
Address
·-_ --~ cV~ fi'd
. ·-------· ·®s --- . • ·--Han,el!..~-~---. ----"1".-' .
!i
+35° 15' 3.76", -78° 24'
19.95"
···~
·. "··, ·-... · ..
Notes 82-625
Phillip Will iams
.,
'
Page I of 1
,.,
(( ~ .I
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i
http://maps.google.com/maps?q=35.251 044N+ 78.405541 W&hl=en&i e=U TF8&11=3 5 .25 ... 1211 8/2007
facil;ty No. 'l'd.--l.o~ c.:;-Time In I J.JJV Time Out------,..,-J. oaie I'LL 1'1 I of
.. Farm Name ph ; I \dp u ;I LW. ~ nu ~ Integrator &!t ag{-;;,=-a'l
Owner ph' fkp ltJ, Jl.( a rn.5 S ite Rep ~fign_~:::L.Lu.l'l____.:::®~~a...p.I{J(!_~(!:..o~_...qc.. __
Operator No.
Back-up _7 _______ ---.::::::==::::::-----No .--------
COC ,./· Circle : CGeaef3i)::> or NPDES
Design Current Design Current
Wean-Feed Farrow-Feed
Wean -Finish l I. I ...,\ J ,, ~\ Farrow-Finish __.. r~t::u r '~ {.II uu L.f' (n (JU Gilts I Boars
Farrow -Wean Others
FREE BOARD: Design ----l./-:----L9 __ _
Sludge Survey G' G ~
Observed 37
Calibration/GPM _...Ol_._._---'-_1_/ __
Crop Yield ___ _ Waste Transfers ~
Rain Gauge .c=·
SoiiTest V Ra i n Breaker--~--
Wettable Acres ~ PLAT ...._
~-
Weekly Freeboard___ Daily Rainfall __....
Spray/Freeboard Drop D..r' ~ ~ &;;;
Weather Codes __ _ 120 min Inspections __ _
1-in Inspections-----
't\'6 'd
Nitrogen (N) Date Nitrogen (N)
\
L\ 5 .'i
PuiiiField Soil n Crop Pan Window
/' (\ \l>..t ..,... --N ''<')X\ {'v\," -0 c_f-
llort <;..__ C::."' 1 l~J .~ -~(
" 1.)
/l ' l<o.. 1+. '~ \"'\ ~ '-) 'J
s (,~ .-0b
r' A
t--n f.· b IJu+·v-----.2 "')'
IU\)
,;..Q s. Uv._p G I .Yy ~~u ~~-~../
(J u ~
I I
1-1 ) ;_ 2 , 1-J
..
Type of Visit a-c-ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I /-81-oft> I Arrinl Time: l10! tiS: I Departure Time: Ill; 61? I County: .5'~~ Region: EJ5 0
Farm Name: .... e(....;J.. ~+-._.·ft<40~~/'::::..._-~M""--'-/Au.~ ....... ....:· a:;· mca.;2iL---L6....:1;:(:!../".~nt~'-' ___ _ Owner Email: -------------
Owner Name: _ _.?----e.f~l_t_~-'-;F-/''----------==W.~~~.:...~::....'/1--;-"'"L.;,.,_,~ ..... s,__ __ _ Phone:
Mailing Address: ----------------------------------------
Physical Address:----------------------------------------
Facility Contact: C:Ze~o kL""Ha~ Title: -----------PhooeNo: ________ __
Onsite Representati\'e: ~~ nC? 1<..-,.,H-r-efor Integrator: pr r:.:5-r-ti;~
Certified Operator: eA//f,.'.n M 11:8"'7 t
. " Operator Certification Number: -------
Back-up Operator: ---------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude: D OD'·D"
Swine
IO Wean to Finish
0 Wean to Feeder
~Feeder to Finish
0 Farrow to Wean
0 Farrow to Feeder
0 Farrow to Finish
0 Gilts
0 Boars -
Otber
ID Other
Design
Capacity
1/t,t:Jo
Discharges & Stream Impacts
Current
Population
J/.~
Wet Poultry
:
10 Layer
0 Non-LayeJ
Dry Poultry
0 Layers
D Non-Layers
D Pullets
D Turkeys
D Turkey Poults
D Other
·-· .. _.,_
~···
I. Is any di scharge observed from any part of the operation?
Design Current
C~pacity Population
I I
-
Disc harge originated at : 0 Structure D Application Field 0 Other
a. Was the conveyance man-made?
b . Did the d ischarge reach waters of the State? (If yes, notify DWQ)
Cattle
0 Dairy Cow
0 Dairy Calf
0 Dairy He ife•
0 Dry Cow
0 Non-Dairy
0 Beef Stocke r
D BeefFeeder
D Beef Brood Cow .. .. . -
De5 ign _ -c~i~ebt ·
Capacity PQpulatlon , ..
t
f
I
r
!
I :
I
I
t
-· ---J
Number of Structures: UJ ~' I'·· , ..
'
DYes ~N o DNA ONE
DYes ~No DNA ONE
DYes ~N o DNA ONE
c . What is the est imated volume that reached waters of the State (gall ons)? I
d . Does discharge bypass the waste management sys tem? (If yes , notify DWQ)
2. Is there evidence of a pas t di scharge from any part of the operation?
3 . Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a di sc harge?
DYes ~No
DYes ~No
D Yes IR!No
11118/04
DNA ONE
DNA ONE
DNA O NE
Co ntinued
• " • !..
I Facility Number: i;J -~£6T Date of Inspection I/ 3 J-o H
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 J8l'No DNA ONE
DYes l;tt.No 0 NA D NE
Structure 5 Structure 6
Identifier:----'-------------------------------------
Spillway?:
Designed Freeboard (in): __ .~-!~?<----------------------------------
ObservedFreeboard(in): _ _,d"'-..::1, ________________________________ _
5. Are there any immediate threats to the integrity of any of the structures observed? DYes
(ie/ large trees, severe erosion, seepage, etc.)
.ld]No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed DYes tiJNo DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any ofthe structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
D Yes 181 No D NA D NE
DYes ~No DNA ONE
DYes li'}No DNA D NE
11. Is there evidence of incorrect application? lfyes, check the appropriate box below. 0 Yes ~No DNA D NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN D PAN> 10% or 10 lbs D Total Phosphorus D failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area
12. Crop typ<(.') ~ t::.'-<' /sP.JdfGr4;~ G-.
13. Soil type(s) ___ _ _ _ _ J PoA
; =
14. Do the receiving crops differ from those designated in theCA WMP? D Yes ~ No DNA D NE
15. Does the receiving crop and/or land application site need improvement? ~Yes ~DNA 0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination'!D Yes 18l.No DNA D NE
17. Does the facility lack adequate acreage for land application? DYes &No DNA 0 NE
18. Is there a lack of properly operating waste application equipment? DYes ~No DNA ONE
Comments (refer to question #):~· Explain any YES answers and/or any reeommen~tion~ or any other comments.: ,
Use draWings offacility to, better ex~Jiain situations. (use-additional pages~ necessary):
e .
~a) fl't:"~'~ J r~ 1::1
If) L :mr: tr6 c~lk) -/t; r-
CPr-t/r;,t. U,le.::-./..s /n E>c-Ymttk
~
L ~-. ,5h;y~ &-lA--m-~ e 1 Phone: ~& ;/6 4!-EX73:J-Reviewer/Inspector Name _, .-
Reviewer/Inspector Signature: ~~ Date: 1.. -63 1-..;:l!iJot..
12128104 Conttnued
j Facility Number: £P.: -&;z5t Date of Inspection I C3Fo4
Reguired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. D WUP 0 Checklists D Design D Maps D Other
DYes ~No DNA ONE
DYes ®No DNA ONE
21. Does record keeping need improvement? Ifyes, check the appropriate box below. DYes 5No DNA D NE
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 I" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the 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
DYes
DYes
DYes
DYes
DYes
DYes
DYes
11128104
~No DNA ONE
RjNo DNA ONE
ijdNo DNA ONE
~No DNA ONE
~No DNA ONE
()a No DNA ONE
tiJNo DNA ONE
~No DNA ONE
~No DNA ONE
{)a_ No DNA ONE
i'JNo DNA ONE
al,No DNA ONE
iance Inspection 0 Operation Review 0 lagoon Evaluation
~ne 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access
DateofVisit: I '3/li/Dt.J. lrrme: I }:oo Facility Number 8c2. H kPS' _... lo Not Operational 0 BeJow Threshold
ermitted f.od [J Coaotitiooally Certffiod [J Registend Date Last Operated 0 , Above Threshold' ---------··
Fann Name: ·····-----~/if ..... ~.J.!b .. ~~-~---···f_~~---················-··························· County: ........... ?~.~;.~~ .................................................. .
Owner Name: .............. .a.;Jl;f..~ ...... ~!Jr i.~.t!!~.............................................................. Phone No: ..... .U.~ ... : .. r±~ ... :.:t5...S: .. 7. .... { .. c..r.!~ ......... .
Mailing Address: ....... ~.~ .. --.. ~~~~ ........ &:!.:::4 ...... J!A: ..................... A~.":!.'t!.~ ~~---J-!f.., _____ P:_~~!!.f................. --·--..
Facility Contact: ..... J!!./.!(.. .... Jt.J..iJli.~f. .......................... Title: ..................................... -.................. Phone No: -·-------------..
Onsite Rep .... -•• , _r./,;lf~~-.J..fam_ __ t.o.!\!.J_{________ Integrntor. ___B:_~4_..f•t:.~L----
certified Operator: ........... ~'f::.~.':::~ .... -~.'1\.!~~---·---·-....................................... Operator Certification Number: .......... -........................... .
Location of Farm:
0 Swine 0 Poultry 0 Cattle D Horse Latitude .....____.I• ._I _ _.I· ._I _ ____.I" Longitude .....____.I• L-1 _ _.I· ._I _ _.I"
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Lagoon D Spray Field D Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in ga!/min ?
d . Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? 0 Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
DYes~
DYes ONo
DYes DNo
DYes DNo
DYes ~
DYes ~
DYes DNo
Structure 6
Freeboard (inches): _ ___;;_;........;.4_~;.:;k:.::j::..:..:..:6::... ---------------------------------
12112103 Continued
fFacillty Number: j'J -G, c1. ~ I Date of Inspection I 3 /16/ olfl
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(H any of questions 4-6 was answered yes, and the situation poses an
immediate public health or enviroumental 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.
0 Excessive Ponding D PAN 0 Hydraulic Overload D Frozen Ground D Copper and/or Zinc
12. Crop type t:rwt~, S !V'"'-tl ~Ail'> . ~<Cue.
13. Do the receiving crops differ with tho e 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 atlor. 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'--\t, ftilJ.,-Js ' t2ro('> VoJt )ood.
f\hct ~ •>1-\. l
Reviewer/Inspector Name
Reviewer/lospector Signature:
12112103
'{-ll t'.; i ~-
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~·
Continued
[Facility Number:~ .2 -C~$" I Date of Inspection I 3 /I~/~ 41
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
D Waste Application D Freeboard 0 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?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified A WMP?
l\'PDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain 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.
0 Stocking Form D Crop Yield Form 0 Rainfall 0 Inspection After l" Rain
/ ~i20 Minute Inspections 0 Annual Certification Form
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
~ONo
0 Yes (g-NC(""
DYes~
DYes
DYes
DYes
113' No violations or deficiencies were noted during this visiL You will receive no further correspondence about this visiL
51~~ ~rvt) 4~ Viii -t<; tLtJ;~Yr-t'"Ho .... a.-.J ~hb/t'"·
~ iLC-4}"""'--'.
12/12/03
D ivision of Environmental Management
Animal Feedlot Operations Site Visitation Record
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General Infonnation;
Farm Name: "T'b"" ;2. '-'
OwnerName: fbihif W ;t\i ~IIOW's
County. . .S~soo
Phone No: 'l1 ·o -~9~ -o z 11
On Site Representative: ~Y~. tJL.t.Moo.d ·. ,. Integrator: T~M~-----
Mailing Address: ?.. 0 • ~ C> '!S \ ~ \ JJ fu d~ 0 U C 0 Y &c I
Latitude: "3 s I IS I 3 Longitude : 7& I .2c.f I Z?
Operation Description; ~ased on design charac:terisdcl)
Typ~ o!Swille No. of Anill'lllls
OSow"'-"
ONursery
QFeedcr
OtlurTypt of Uwutock: F; ~ \5 hi f'l lit
u
Typ~ of Poul.try No. of ArUmiUs
0~
CNcm-Layu
Numb~r of AnimDls:
T~oJCaltk
CDairy
CBa:f
No. of AnimaU
Nllmber of Lagoons : t (include in the Drawines and Observations me freeboard of eac:h Jaaocm) ·.
Facility IDSJ!«tiop;
~oon . . .
Is Iagoon(s) freeboard less than 1 f?ot + 2S year 24 ~our_ storm s_torage?:
. Is seepage observed from the. lagoon?:
Is erosion observed?:
Is any discharge obServed?
0 Man-ln/IIU 0 Not Man-IIIDil.e
Cover Crop
Docs the facility need more acreage for. sj,raying?:
Does the cover ~rop need improvemeat?:
( list tM crop$ wmch nud improvemmt)
Crop type: Cser.l. Acreage:~7.:.._... ___ _
Setbaclc Criterill
Is a dwelling located withiri 200 feet ~i waste. appli~on?
Is a wen located within 100 feet of .wasu;· application? : .· · -~ · . .
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream?
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream?
AOI-Janllai'J 17,1996
YesD No.8
YesD No~
YesD ·Nol.il
YesD No9
YesD No~
YesO NoB
. ~.. ~ .
Yes D .. No~. · :.-
Yes Cl '··,No Q . :.. ...
YesO No(8-
Y~Cl No&
'
i_,J MainteiUlnce
Does the facility maintenance need improvement? YesQ
YesQ
YesQ
.YesO
No&.
No .Ill
NoO
NoQ
Is there evidence of past discharge from any part of the operation?
Does record keeping need improvement?
Did the facility fail to have a copy of the Animal Waste Management Plan on site?
Explain any Yes answers,_· --------------------------
I •
cc: Facility Asstssmenl Ullil
Drawin~ or Observations;
AOI-January 17,19H
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