820626_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quality
Structure Evaluation
0 Referral 0 l(mPro·Pnt•v Denied Access
Date of Visit: I a;>'V Q:~A-.~·i ~~Arrival Time:l/0 1, VO 8J-Departure Time:l -lo /l_.?> fcounty: Region: n~
Farm Name: Th o II\.+ a='\ /i~A-J::,... f .t"l <',.,)I ,fJdJ Rr"i>wner Email:
Owner Name: Ro 6 ~vvf}: I hI v vl ~0"3
I
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I . Is any di scharge observed from any part of the operation ?
Discharge originated at: 0 Structure 0 Application Field
a . Was the conveyance man-made?
Phone:
0 Other:
b. Did the di scharge reach waters of the State? (If ye s, notify DWR)
c. What is th e estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: &'P·5£r~
Certification Number: ( 6 7 S /
Certification Number:
Longitude:
DYes ~NA ONE
DYes 0No
0 Yes 0No
d. Does the discharge bypas s the waste management system? (If yes, notify DWR) 0 Yes 0No (1NA 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 di sc harge?
Page I of3
0 Yes
0 Yes
[3-No DNA ONE
LJNo DNA ONE
214/2015 Continued
IFacili~ Number: ~.}: -( 9' {: I Date of Inspection: ~D iJ{JN{ WJ
Waste Collection & Treatment
4. 1.;<> storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure l Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 9\ S
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 ~NA ONE
DYes 0No ~ONE
Structure 5 Structure 6
0 Yes [3--NO D NA D NE
DYes ~ DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~ DNA ONE
DYes ~DNA ONE
DYes [31[o DNA ONE
DYes ffNo DNA ONE
I I. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~ D NA D NE
D Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): If~ c flct.l--<---$' 6 0
13. Soil Type(s):
I
14. Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box.
DwuP Dchecklists Onesign D Maps 0 Lease Agreements
DYes ~ DNA
DYes ~ DNA
DYes G}-Nc) DNA
DYes ~ DNA
DYes g-No DNA
DYes ~ DNA
DYes [}-NO DNA
Oother:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~ DNA ONE
0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 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? D Yes Bi'lo 0 NA D NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? D Yes ~o 0 NA 0 NE
Page 2 of3 21412015 Continued
IFacili~ Number: I nate of Inspection: .lo fJO c-1 / ~
24 . Did the facility fai l to calibrate waste application equipment as required by the permit?
25!ls the facility out of compliance with permit conditions related to sludge? If yes , check
the appropriate box(es) below.
0 Yes (g1'fo DNA D NE
0 Yes @}--NO D NA 0 NE
0 Failure to complete annual sludge survey 0 failure to develop a POA for sl udge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal ?
29. At the time of the inspection did the facility pose an odor or ai r 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, c heck the appropriate bo x below.
0 Yes
DYes
DYes
0 Yes
0 Yes
0 Yes
0 Application Field D Lagoon/Storage Pond 0 Other: --------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 0 Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 0 Yes
34. Does the facility require a follow-up visit by the same agency? 0 Yes
[2YNo DNA
[3'"No DNA
~ DNA
~DNA
~ DNA
~ DNA
[2J'No DNA
~0 DNA
[LfNo DNA
Comments (refer to question#): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawines of facility to better explain situations (use additional pages as necessary).
Cttl-lo 1\\.f I~V\ -
g ~J~~ sIt J'!Jl'(l
l~-J-1~
/J--J--d--11
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/I nspector Name: 0\\\ b ~ \'\.~
Reviewcrnnsp<e!O< s;gnatu"' () JPJJ IJ..~
PhoneHID -l\~.3-333«
Date : dQ ~,\ \-t
Page 3 of3 11412015
.. '}'
Operation Re\'iew 0 Structure Evaluation
Reason for Visit: 6 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1/0~4. Fl Arrival Time: I AOt(jO /I Departure Time: I /1~~D~ I County: 5) ~ Region:P:2.1)
Fa.m Nam., Th~-tihg.J!&y!« f&tW ·FlU"" Own" EmaU'
Owner Name: R o.kd-1~~ Phone: -------------------
Mailing Address:
Physical Address:
Facility Contact: _(_~_J._I_1_g=-:::;l-_IA......~V:....._:~;._;_--Title:
Onsite Representative: l ( ------------------------
Certified Ope•ato" ~ Jb !!'Hh
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any di scharge observed from any part of the operation'!
Di scharge originated at : D Structure 0 Application Field
a. Was the conveyance man-made?
D Other:
b. Did the dis charge reach water s of the State? (If yes, notify DWR)
c. What is the estimated volume that reached wa te rs of t he State (gallons)?
Phone:
Integrator: P M..f&, ~
Certification Number: ~/ ...... ~"-'-i7,..... . .L.5..._/ ____ _
Certification Number:
Longitude:
D Yes ~o DNA D NE
D Yes 0 No B'NA ONE
0 Yes 0No B NA O NE
d. Doe s the discharge bypass th e waste management system? (If yes, notify DWR) 0 Yes 0No c{NA ONE
2. Is there evidence of a pas t discharge from any part of the operation?
3 . Were there any o bservable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge'?
Page 1 oj3
0 Yes
0 Y es
[3'No DNA ONE
dNo DNA ONE
21412015 Continued
IFacm-,· Number: I Date oflnspection: /() $?./ fl
')'aste 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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ,3 (
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~DNA ONE
DYes 0No ~ ONE
Structure 5 Structure 6
DYes ~o DNA ONE
D Yes 0"No 0 NA D NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
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)
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 0 NA D NE
0 Yes [d'"No 0 NA D NE
0 Yes [d'No DNA 0 NE
0 Yes DNA ONE
II. Is there evidence of incorrect land application'? If yes, check the appropriate box below. D Yes
~0
~No DNA ONE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): (3~-lfr}B&~
13. Soil Type(s):
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate ofCoverage & Permit readily available?
20. Does the facility fail to have all components ofthc CA WMP readily available? If yes. check
the appropriate box.
OwuP Ochecklists D Des ign D Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes ~No DNA ONE
0 Yes @No DNA ONE
0 Yes [B""No DNA ONE
0 Yes c:rNo DNA ONE
0 Yes @No DNA ONE
0 Yes [1'No DNA ONE
DYes [3'"No DNA ONE
00ther:
DYes @"No DNA ONE
D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected. did the facility fail to install and maintain rain breakers on irrigation equipment?
Page2of3
0 Yes []No
DYes ct'No
DNA ONE
DNA ONE
2/4120/5 Continued
IFadlil)' Number: 81:< 6 ~{, I loate oflnspection: fD ~An I
2}. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes ~o D NA 0 NE
25. Is the facility out of compliance with permit conditions related to sludge? Ifyes, check 0 Yes [?No 0 NA 0 NE
the appropriate box(es) below.
D 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 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? Ifyes, check the appropriate box below.
D Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
DYes
DYes
DYes
DYes
DYes
0 Yes
0 Yes
0 Yes
DYes
[i('No DNA
G3"No DNA
~0 DNA
G(No DNA
[2(No DNA
~0 DNA
C(No DNA
@"No 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 eiplain situations (Qse additional pages as necessary).
CA;\ 4 t~;~ '"' [~ '-' t c-{ j,
V~tS~t-~~ {~ ~ /~U~ (9-'-" ~ p ... ). f
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/Inspector Name: &.11l D~~
Reviewer/Inspector Signatur-e-: ~-{b...~'-:':""''"-~i:i!::_...J_I£TI:::-:....""'~t~-:....:::::~~--~~~--~~~~~~~~--~~--~~~~~~~~~~~~
Phon~~ fO. ru-3351(
Date: /b ~+l (1
Page3 of3 21412015
~pliance Inspection
Reason for Visit: outine 0 Complaint 0 FoUow·up 0 Referral 0 Emergency 0 Other
Date of Visit : I qp..cfl;; I Arrival Time: Jj;{l:(.~ P I Departure Time: I S t ~0 B County: SA!J
FarmName:JltaM.bn ~"\.~ Ptw ·r-~ OwnerEmail:
OwnerNam" C\1.t~)Jk~ Phone'
Mailing Address:
Physical Address:
Region: t=i.f{:)
--------------------------------------------------------------------------
Facility Contact: __ CL£~=:lo.q._f'L-__J~...:::::=...:...::._<ft...li£.l/(L..._ Title:----------Phone:
l ( Integrator: e ~ ~ ty
CYl.JJ 1\4 '0{'\.i----Certifi<ation Number' :J.......:b=---...;..1_5"_/ __ _
Onsite Representative:
Certified Operator:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any di scharge observed from any part of the operation? DYes ~DNA ONE
Discharge origi na ted at: 0 Structure 0 Application Fie ld 0 Other:
a. Wa s the conveyance man-made? DYes 0No ~A ONE
b. Did the discharge reach waters of the State? (If yes , notify DWQ) 0 Yes 0No ~ ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d . Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0 No ca-m: 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
~ DNA ONE
~0 DNA ONE
214/2011 Continued
l»ote ofln•~e<tion:. 'f~ a
W.aste CoUection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Id entifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): n
5. Are there any immediate threats to the integrity of any of the struc tures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
D Yes ~DNA
DYes 0No g-r;fA
Structure 5 Structure 6
DYes ~o DNA ONE
DYes ~o DNA ONE
Jf any of questions 4·6 were answered yes, and the situation poses an immediate public hea lth or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the stru ctures lack adequate markers as required by the permit?
(not applicable to roo fed pits, dry stacks, and/or wet stacks)
9 . Docs any part of th e waste management system other than the waste structures require
maintenance or improvement?
Waste Application
DYes 81Jo
DYes [211io
D Yes @No
DNA ONE
DNA ONE
DNA O NE
I 0. Arc there any required buffers, setbacks, or compliance alternatives that need D Yes (A"'No D NA 0 NE
maintenance or improvement?
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~o D NA D NE
D Excessive Ponding 0 Hydraulic Overload D Frozen G ro und 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. C rop Type(s): ~~~ H d: P S b '0
13 . Soil Type(s): {1 \ 6JL /(b
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determinati on?
Pag e 2 t~/3
0 Yes
DYes
DYes
DYes
D Yes
DYes
DYes
Oother:
DYes
[H'No DNA ONE
~0 DNA ONE
~0 DNA ONE
[!'No DNA ONE
[t{No DNA ONE
~0
~0
DNA O NE
DNA O NE
[2(No
21412 014 Continued
[Facm_!l: l'lnmbe" Kl. . tiJ:i I !Date oflnspection' 'llttf a I
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes lifNo 0 NA 0 NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes ~ 0 NA 0 NE
the appropriat e 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 fac ility 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 representati ve 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)
DYes
0 Yes
DYes
DYes
DYes
DYes 31. Do subsurface tile drains exist at the facility ? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes
33 . Did the Reviewerllnspector 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
[fNo DNA ONE
[{No DNA ONE
[!(No DNA ONE
~0 DNA ONE
c(No DNA ONE
(Z(No DNA ONE
[Z('No DNA ONE
llfNo DNA ONE
~0 DNA ONE
Comments (refer to question#): Explain any YES an~~~rs. ~IJII{(Jr any additional recommendations o~ an~:ot~~·r;~p~J!I~~~~·~:,J;t:'S§lf?,
Use drawings offacility to better explain situations·:(use:additioilaFpage5 as necessary). · .. · · ··f~. ·· '1f£<~-'u;~~IJ.;!ft~ ... ~~;}fft·
Reviewer/Inspector Name: Phone: Lf33-3 S 3 t
Dat" ~ !!l' b
214. 14
R eviewer/Inspector Signature:
Page3 of3
Technical Assistance
Reason for Visit: 0 Other 0 Denied Acces s
Date of Visit: J}3#4;b ~rrival Time:] f J -~00 ] Departure Timed (J~ l.fo ] County:VJi-!'l
Farm Name: T ~ ~ ~*-1 t \Pl -J1?av ~ Owner Email:
OwnerName: &.6~ Cf1#t!l~ Phone:
Region:~
Mailing Address:
Physical Address: --------------------------------------------------------------------------------------
Facility Contact: -...::~'-""=-Lr..L:~=s__;~;;:;,..,;_~~r ___ Title: _______ _
Onsite Representative: rf
Certified Operator:
Back-up Operator: Certification Number:
Location of Farm: Latitude:
Discharges and Stream Impacts
LIs any discharge observed from any part of the operation?
Discharge originated at: 0 Structure D Application Field 0 Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the 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 observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
Longitude:
DYes ~DNA ONE
0 Yes 0 No ~ O NE
DYes 0No OJ»A O NE
D Yes 0No ~ ONE
0 Yes ~ D NA O NE
0 Yes No D N A O NE
1141201 I Continued
I Facility Number: -t;a;b I loate of Inspection: J1 I({;G /1 I
\vaste Collection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) le ss than adequate?
a . If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees , severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~DNA ONE
DYes 0No ~ONE
Structure 5 Structure 6
DYes ~DNA ONE
0 Yes [3'1Clo 0 NA 0 NE
If any of questions 4-6 were answered yes, and tbe 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?
0 Yes (LJ1il'o
DYes~
0 Yes {2fNo
DNA ONE
DNA ONE
DNA ONE
DY es~ DNA ONE
11. Is there evidence of incorrect land application? Jfyes, check the appropriate box below.· 0 Yes p.xo 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 . 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of A cceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): :g .•r-fo\.A....k ·HtP Sb"V
13 . Soil Typ e(s ): Bq (.J, ·IJo
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 faciliry lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the faciliry fail to have the Certificate of Coverage & Permit readily available?
20. Does the faciliry fai l to have all components of the CAWMP readily available? If yes, check
the appropriate box.
0 WUP 0 Checklists 0 Design 0 Maps 0 Lease Agreements
2 I . Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes EfNo DNA ONE
DYes ~ DNA ONE
0 Yes ~No DNA ONE
D Yes ~ DNA ONE
0 Yes [(No DNA ONE
0 Yes ~0 D NA ONE
0 Yes [1'No DNA ONE
00ther:
D Yes c{No DNA O NE
0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Weather Code .
0 Rainfall 0 Stocking D 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? 0 Yes d 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 214/2014 Continued
(FaCility Number: I Date oflnspection:Jg Q JJ
14. 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 ~ DNA ONE
DYes ~ DNA ONE
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? DYes ~0 DNA
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes ~0 DNA
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes ~0 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? DYes [j'No 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 DYes ~ DNA
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? lfyes, 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 ~0 DNA
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes [Lf'No DNA
34. Does the facility require a follow-up visit by the same agency? DYes 0No 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).
(;_-' i-'Y
(J--~' tl{
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: lf3J-t 3 3 3 '(
Date: _....!.N--=....~ __;_:~~~ J_
Page3of3 214/2011
I ype of Visit: go-Cbm�pliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Q Iinutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: rI1�Uy��-����-�� Arrivral Time: �7 d Departure Time: County: �-F— Region:
Farm Name: / 1Mect4 E¢J IA�y /tGj Owner Email:
Owner Name: ''ILIMPPl— - / /jn f A *41A Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: it
Certified Operator: �PIL U
Back-up Operator:
Location of Farm:
Title: l / Pe'-
Onsite
C
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
161 Sj
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes �❑ NA ❑ NE
❑ Yes ❑ No E�J`NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
©'ZA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
Design Current.=
* ' Design Current,t�_�A,,;`__ Design Current
[:]Yes
❑ No
.�
it
2. Is there evidence of a past discharge from any part of the operation?
Swine
Capacity Pope_
WtPoe°lry� .
Capacity
Popsl% Capacity Pop.
Wean Finish
LDXo
❑ NA
❑ NE
of the State other than from a discharge?
to
La er
Dai Cow
Wean to Feeder
Non -La er
_
�,) Dai Calf
Dai Heifer
Feeder to Finish-
Farrow to Wean
;,, t �' qil
Design
_
Current,, D Cow
Farrow to Feeder
„ D P._oult .
Ca aci
P,o " " Non -Dairy
Farrow to Finish
Layers
'M Beef Stocker
GiltsW
Non -Layers
Beef Feeder
Boars
Pullets.
jBeefBroodCow
Turkeys
Other
��2 TurkeyPoints
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes �❑ NA ❑ NE
❑ Yes ❑ No E�J`NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
©'ZA
❑ NE
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)
[:]Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[340
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
LDXo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 2/412011 Continued

...
Waste Collection & Treatment
I nate of Inspection: I[) Afi 1/'-{f{
I DYes~ DNA ONE
I Facility Number:
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard ? DYes Q No DNA ONE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? QYes ~DNA ONE
(i.e., large trees, severe erosion , seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a D Yes ~DNA ONE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or 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 structure s require
maintenance or improvement?
Waste Application
I 0 . Are there any required buffers, setbacks, or compliance alternatives chat need
maintenance or improvement?
II. Is there evidence of incorrect land application? If yes, check the appropriate box below.
0 Yes ~ DNA ONE
QYes ~ DNA ONE
DYes ~ DNA ONE
0 Yes ~ DNA ONE
DYes ~DNA ONE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn , etc .)
0 PAN 0 PAN > 10% or lO lbs . 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12 . Crop Type(s): Se~ -8Go vJ,4 _s;f
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 sec ure and/or operate per the irrigation design or wettable
acres determination?
Page2of3
0 Yes
0 Yes
0 Yes
DYes
QYes
0 Yes
DYes
Oother:
0 Yes
~0
~0
~0
~0
~0
~0 ~0
~0
DNA ONE
DNA ONE
DNA ONE
DNA ONE
D NA ONE
DNA ONE
DNA ONE
114/2 011 Continued
[Facility Nu~ber: J'):: -~ I I nate of lospection: z72A ~~ ttt I
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 pennit conditions related to sludge? If yes , check 0 Yes ~ DNA
the appropriate box(es) below.
0 Failure to complete annual sludge survey 0Failure to develop a POA for slud ge 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 ~0 DNA
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes ~ D NA
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or documen t DYes g>ro DNA
and report mortality rates that were higher than normal? I
29. At the time of the inspection did the facility pose an odor or air quality concern? 0 Yes ~ 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 DYes O'No DNA
permit? (i.e., discharge , freeboard problems, over-application)
31. Do subsurface tile drains ex ist at the facility? If yes, check the appropriate box below. DYes ~ DNA
0 Application Field D Lagoon/Storage Pond 0 Other:
32. W ere any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~0 DNA
33 . Did the Reviewer/In spector fail to discuss review/inspection with an on-site representative? DYes ~ DNA
34. Does the facility require a follow-up visit by the same agency? DYes ~0 DNA
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any otber comments.
Use drawings offacility to better explain situations (use additional pages as necessary).
oJ,b~~[~
<0 ((,l4\0 s.._,~,
Reviewer/Inspector Name:
!. b '-~L( _, I;L
,t 1-'-nt-1.3
O NE
ONE
O NE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/Inspector Signature: Dat e: -J..Iotc~Kt._F=Wr~ \T+-~ __ 214~1;\ Page3of3
ompliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ~outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I S-p-131 Arrival Time:l ;;lt. 00 I Departure Timed Jt. 2 0 I County;~b-'-Region: p;e 0
Farm Name: --rh pt""'n TO?"--' En"trr-rc~J ~~ tJ""CUJ~wner Email:
Owner Name: '"Kt:lzc;=f-:rb 0 ri!Tf; """"""' Phone:
Mailing Address:
Physical Address: -------------------------------------------
Facility Contact: Cvcf6 ~ (U.J ivk Phone:
Onsite Representative: Integrator: JL>~z->~
Certified Operator: Certification Number: / (q Zr/
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? DYes ~No DNA ONE
Discharge originated at: 0 Structure D Application Field 0 Other:
a. Was the conveyance man-made? DYes DNo DNA ONE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes DNo DNA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes DNo DNA ONE
2. [s there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes ~No
DYes ~No
DNA ONE
DNA ONE
21412011 Continued
!Facility Number: I Date of Inspection: r »-I 3
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 Structure2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): I Cf
Observed Freeboard (in): CJ 3
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there s tructures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes [3.No 0 NA 0 NE
0 Yes 0 No 0 NA 0 NE
Structure 5 Structure 6
0 Yes ~ No 0 NA 0 NE
0 Yes ~No 0 NA 0 NE
If any of questions 4·6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures 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 I2S No 0 NA 0 NE
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes g) No 0 NA 0 NE
I 1. Is there evidence of incorrect land application ? If yes, c h eck the appropriate box below . D Yes ~ No DNA 0 NE
0 Excessive Ponding 0 Hydraulic Overl oad 0 Frozen Ground 0 Heavy Metals (Cu , Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. D Tota l Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12 . 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 p e r the irrigation design or wettable
acres determination?
17 . Does the facility lack adequate acreage for land application ?
18 . I s there a lack of properly operating waste appli cation equipment?
Required Records & Documents
19. Did the facility fail to h ave the Cenificate of Coverage & Permit readi ly available?
20. Does the facility fail to hav e all components of the CAWMP readily available? If yes, check
the app ropriate box .
0WUP 0Checklists 0 Design 0 Maps 0 Lease Agreements
2 1. Does record keeping need improvement? If yes, check the appropriate box be lo w.
DYes ~No DNA ONE
D Yes ~No D NA ONE
DYes 1;81 No D NA O NE
DYes ~No D NA ONE
DYes ~No DNA ONE
D Yes ~N o DNA ONE
DYes j3No DNA ONE
Oother:
DYes [&No DNA ONE
D Waste Application 0 Weekly Freeboard 0 Waste Analys is 0 Soil Analysis D Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthl y and I" Ra infa ll In spections 0 Sludge Survey
22. Did th e facility fail to install and maintain a rain gauge? 0 Yes [XI No 0 NA 0 NE
23. If selected, d id the faci lity fail to install and m a intain rainbreakers on irrigation equipme nt ?
Page1of3
0 Yes ~No 0 NA 0 NE
114110 II Continued
! •
I Facili~ Number: AA' -t-1 ~ I .. I nate of Inspection: 5'"-tl,?-1 ~
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes I!JNo DNA
25 . Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes .f6J No DNA
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? O Yes ~No DNA
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes ~No DNA
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes (&No 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? DYes ugNo DNA
If yes, contact a regional Air Quality representative imme diately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes ~No DNA
permit? (i.e., discharge, freeboard problems, over-appli cation)
3 1. Do subsurfa c e tile drains exist at the facility? If yes, check the appropriat e box below . DYes fiJ No DNA
0 Application Field D Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which c a use non-compliance of the permit orCA WMP ? 0 Yes rgJ No DNA
33. Did the Reviewer/Inspector fail to discuss review/inspectio n with an on-site representative ? DYes ~No DNA
34 . Does the facility require a follow-up visit by the same agen cy? DYes (gNo DNA
Comments (refer to question#): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility tq better explain situations (use additional pages as necessary).
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Revi e wer/Inspector Name:
Reviewer/Insp ect or Signature :
Page3of3
Phone: 9/0 -#"J>-32LP
Date: ,y~(3
21411011
Compliance Inspection
Reason for Visit: <V1{outioe 0 Complaint
DateofVisit: I4V~\\ct I Arrival Time:! \~'.:>0~ Departure Time:! t !Ot?pm I County: S4mpsofl Region: Pf{D
Farm Name: 1h of\N \-Qt"'\ ~ n-\p B.\> R"'t ::,LS (Kav fSf!I\1J Owner Email:
Owner Name: ~ob~--\-:ShoR..N\oN Phone:
Mailing Address:
Physical Address: -------------------------------------------
Facility Contact: CL.u(\~~5 \?;> fot "VJ :rc..K Title:----------Phone:
Onsite Representative: _~.;...;.:.~~~~f"------------------lntegrato~Re>\M £
'
Certified Operator: \.... C.i?.BX§s 'Tht>BN\of\)
Back-up Operator:
Certification Number: ...:\~l.Jila....:L::..:!5~\ _____ _
Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operatio n? D Yes ~o
Discharge originated at: D Structure D Application Fi e ld D Other:
a. Was the conveyance man-made? DYes 0No
b. Did the disch arge reach wa te rs of the State? (If yes. notify DWQ) D Yes DNo
c. What is the estimated vo lume that reached waters of the State (gallons)?
d. Does the d isc harge hypass the waste management system'! (If yes, notifY DWQ) D Yes 0 No
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 disch arge?
Page I of3
D Yes 0 No
D Yes ~No
D NA ONE
(ifNA ONE
~NA ONE
~A O NE
D NA ONE
D NA ONE
1/412011 Continue d
!Facility Number: fl}. -fo'C). L I Date oflnspection: '-'( 1-\ \¥?'
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure2 Structure3 Structure4
Identifier: ~J_ -----
Spillway?:
Designed Freeboard (in): \~ _ _...;. __ _
Observed Freeboard (in): Q. ~ __,.,__ __ _
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~o DNA ONE
DYes ~o DNA ONE
StructureS Structure 6
DYes 1!1'"No DNA ONE
DYes ~0 DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental tbreat, notify DWQ
7 . Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ji2'No
DYes 12J'No
DYes (l:}No
DNA ONE
DNA ONE
DNA ONE
DYes ~o DNA ONE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. DYes [}?'No DNA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Gro und 0 Heavy Metals (Cu, Zn, etc.)
D PAN D PAN> 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/S ludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12.CropType(s): J;:,~Jl.sn.\.)0 Po (GRA2..0,f£G 0
13. Soil Type(s): ~ () t,D: L) ~ ""t> \ \'{ b 19' _' N n ~?u
14 . Do th e receiving crops differ from those designated in th eCA 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 dete rmination ?
DYes
DYes
DYes
DYes
DYes
DYes
D Yes
00ther:
DYes
[2J'No
[g'"No
~0
~0
0"No
et'No
~0
~0
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
• • -4
!Facility Number: I Date of Inspection: L\\ L\) \ "'). ' ~
24. Did the facility fai l to ca lib ra te waste appli cation eq uipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to s ludge? If yes, check
the appropriate box(es) below .
D Yes ~o
D Yes IJ3""N o
D NA O NE
D NA O NE
D Failure to complete an nua l sl udge s urv ey 0Fai lure to deve lop a POA for s ludge leve ls
D Non-compli ant sludge levels in any lagoon
List structure(s) and date of first survey in dicating non-compliance :
26. Did the faci li ty fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus Joss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hou rs and/or document
and report mortality rates that were higher than no rmal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality r epresentative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as req uired by the
permit? (i.e., discharge, freeboa rd problems, over-application)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Yes [S(i D NA O NE
0 Yes ~N ~NA O NE
0 Yes [S?No DNA O NE
0 Yes [g'No D NA O NE
D Yes (k(No D NA O NE
D Yes ~!!{No DNA O NE
D Appli cation Field D Lagoon/Storage Pond 0 Other: ------------------------
32. We re any additional probl ems noted which c au se non-compliance of the permit orCA WMP? 0 Yes ~No D NA O NE
33. Did the Reviewer/In spector fail to discuss review/inspection with an on-site representative? 0 Yes ~No D NA O NE
34. Does the facility require a follow-up visit by th e same agency? 0 Yes ~0 D NA O NE
Reviewer/Inspector Nam e: Phon e: sO~~ ~KS\
Reviewer/In spector Signatu re : Date: 4\\B.ll(b
Page 3 tJf3 21412 011
Date of Visit:
Owner Name: Phone:
Mailing Address:
PhysicaiAddress: --------------------------------------------------------------------------------------
Facility Contact: Phone:
Onsite Representative: --~5~a..........r.::::=.=e.,....:a..:::...... ___________________ _
Certified Operator: ~ ~
Integrator: p~~
Certification Number: Lv?SI
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impa cts
1. Is any di sc harge ob serve d fro m an y part of the o p eratio n? D Yes ~ DNA ONE
Discharge originated at: D Structure D A pplica tio n Field D O ther :
a. Was the co nveyance man-made? DYes 0No L(NA ONE
b. Di d the dis charge reac h waters o f the State? (If ye s, noti fy DWQ) DYes 0 No (g1l A ONE
c. Wh at is the estimated volume that reached wate rs of the State (gall o ns)?
d . Does th e discharge byp ass the waste m anage ment system? (If ye s, n ot ify D WQ) DYes 0No ~A ONE
2 . Is there evi den ce of a pas t di sc harge from an y p art o f the operation?
3. Were the re any o bs ervable adverse impacts or potential adverse i mpacts to the waters
o f th e State othe r th an from a dis charge?
Page 1 of3
D Yes
D Yes
~0 DNA ONE
~ DNA ONE
21412011 Continue d
I Facility Number: ~ loate of Inspection:
Waste Collection & Treatment
4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a . I f yes, is waste level into the structural freeboard?
Structure! Structure 2 Structure 3 Structure 4
Identifier: li)
Spillway?:
Designed Freeboard (in): 19
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 prope rl y addressed and/or managed through a
waste management or c losure plan?
DYes
DYes
Structure 5
~DNA
~DNA
Structure 6
DYes~ 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 permit?
(not applicable to roofed pits, dry stacks, and/or wet s tacks)
9 . Do es 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 comp liance alternatives that need
maintenance or improvement?
DYes~
DYes~
DNA ONE
DNA ONE
DYes ~ DNA ONE
DYes ~o DNA ONE
II . Is there evidence of incorrect land application ? If yes , check the appropria te box below. 0 Yes ~o D NA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Froze n Ground 0 Heavy Me tal s (Cu, Zn, etc.)
D PAN 0 PAN > 10% or 10 lbs. D Total Phosphorus 0 F ailure to In corporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidenc e of Wind Drift 0 Application Outside of Approved Area
~ ( C-...vi? I :5Cro 12. Crop Type(s):
13. Soi l Type(s):
I I
14 . Do th e receivi n g crop s differ from those des ignated in theCA WMP ?
15 . Do es the recei ving crop and/or land application sit e n eed improveme nt?
16 . Did the facility fail to secure and/or operate per the irrigation desibrn o r wettable
acres determination?
17 . Does the facility lack adequate acreage for land ap pli cation ?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19 . Did the facility fail to have the Certificate ofCovcrage & Permit readi ly available?
20. Does the facility fail to have all components of the CA WMP readil y available? If yes, check
the appropriate box.
0 WUP O checklists 0 Design 0 Maps 0 Lease Agreements
2 1. Docs record keeping need improvement? If yes , che ck the appropriate box below.
D Yes
DYes
DYes
0 Yes
0 Yes
DYes
DYes
00ther:
DYes
UJ-'No
~0
DNA ONE
DNA ONE
QNA ONE
DNA ONE
DNA ONE
~DNA ONE
~DNA ONE
~DNA ONE
0 Wa ste Applicati o n 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute In specti ons 0 Monthly and I" Rainfall In spections 0 Sludge Survey
22. Did the facility fail to in stall and maintain a rain gauge? D Yes ~ DNA 0 NE
23. If selected, did the facility fail to in stall and mai ntain rainb reakers on irri gation equipment? 0 Ye s 0 No ~ 0 NE
Page2of3 114/2011 Continued
(Facility Number: 4k
24. Did the facility fail to calibrate waste application equipment as required by the penn· ?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
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 provide documentation of an actively certified operator in charge?
27 . Did the faci lity fail to secure a phosphorus Jo ss assessments (PLAT) certification?
Other Issues
28 . Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency siruations 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
DYes
D Yes
DYes
DYes
0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? D Yes
33. Did the Reviewer/Inspec tor 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
[ri<o
0No
[B1i'"o
~
~
~
~
~0
~
DNA ONE
DNA ONE
DNA O NE
~ ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA O NE
D NA ONE
DNA ONE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pageS as necessary).
Reviewer/Inspector Name: fL.L~ 7
Review.,./Inspeoto' Signatu<e~..::J>f=~:....L------------------------­
PageJ of3
Phone: q;o -03--333-,
Date: ~~~}.....:;..f+-}....:.....J J_ r,
21472011
2 -OS-20/0
ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~ne 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I!-Z9-IO I Arrival Time: ko: SS At I Departure Time: l11: :1!; ..A.-I County: SO'!'ps-~;.~ Region: rLO
Farm Name: "T/torJV f-DN e",,rk.,r~v/..$·~s {Nt.w ri•r--) Owner Email:
I --------------------------------------
OwnerName: Rob~~r+ Tit.ov-N+oN-:..::.... _________ _ Phone:
Mailing Address: ----------------------------------------------------------
Physical Address: ----------------------------------------------------------------------------------------
Facility Contact: c~,h5 g.,.YWt'<...K.. Title: 7'Zc..4 · $0e.c.. · Phone No : _________________ _
Oosite Representative: ---------------------------------------------Integrator: Co AO<r/ ~ h ~',_
Certified Operator: -------------------------------------------------Operator Certification Number: ----------------
Back-up Operator: ---------------------------------------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I . Is any di scharge observed fro m a ny pa rt of th e operation? D Yes ~DNA ONE
Di scharge ori g inated at : 0 Structure 0 Appli cat ion F ie ld 0 Other
a. Was the conveyan ce man -made? D Yes 0 No !31'iA ONE
b. Did th e di sc harge reach waters of the State? (If yes, not ify DWQ) D Yes D No G:tNA ON E
c. What is the estim ated volume that reac hed waters of the State (gallons)? I
d. Does di scharge by pass the waste man a gement system? (If yes, notify DWQ) DYes D No 131ft\ ONE
2. Is th ere evidence of a pas t discharge from any part of the operation?
3. W ere there any adverse imp ac ts or pote ntial adve rse impacts to the Wa ters of the State
other than fr om a di sc harge?
DYes ~ DNA ON E
DYes ~DNA ONE
12/28/04 Continued
I Facility Number: B 2-~ 2 ~I Date of Inspection 1/-2 9-I 0 ]
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
DYes
Structure 5
DNA ONE
DNA ONE
Structure 6
Identifier:------------------------------------------
Spillway?:
Designed Freeboard (in): ------------------------------------------
Observed Freeboard (in): _..:2=-.:3"""""--------------------------------------
5. Arc 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
DYes
~DNA ONE
~0 DNA
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes DNA ONE
11. Is there ev idence of incorrect application? If yes, check the appropriate box below. 0 Yes DNA ONE
D Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN D PAN > 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
12. Crop type( s) -B~~:..!.~....:........,==:::""-::..d~.::..._::::::...___!_((.:::G:....:h:)-=..:"\~e.::....).!._,,,__:=:~..:..:kA-.:::::.:L:.:.·I...::G~~~~IJ~{'=-=o::.:':....::S:_.:...::)~J,__..::!.S::....:u:...:jo6.=.:.::: ..... :::c..~v-f-.!...' _w....::..::....:,· 111...:...-k.¥-~_A-_IJ.:....N...:....-l_~...!....:..-.5
13. Soil type(s) {30 BJ &J a...B J No 8 1 lib .4-
14. Do the receiving crops differ from those designated in theCA WM P?
15. Does the receiving crop and/or land application site need improvement'!
DYes
DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? 0 Yes
~DNA ONE
~DNA ONE
~0 DNA D NE
17. Docs the facility lack adequate acreage for land application?
I X. Is there a lack of properly operating waste application equipment?
DYes ~DNA ONE
DYes ~DNA ONE
Phone: 9/~. y33. 33 00
Date: 1-27-2"10
12128104 Continued
'
I Facility Number: 82 -62~1 Date of Inspection 11-2~-10
Required Records & Documents
19. Did the facility fail to have Certificate ofCoverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes , check
the appropriate box . D WUP 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 D Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
. 23 . If selected, did the fa c ility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste appli cation 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? (i e/ di scharg e, freeboard problems, over application)
32. Did Reviewer/lnspector fail to discuss review/inspection with an on-site representative?
33 . Does facility require a follow-up visit by same agency?
DYes l31'lo" DNA ONE
DYes ~ DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes DNA ONE
DYes ~.DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~ DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
• .... ·~ ~-' I ', • ~ ~ ! : ·~ I { _.~ :' ."'~ ~_. • • ' ~
12/28104
.:
IO-o5"-2oo9
Type of Visit e-fO"mpliance Inspection
Reason for Visit (31fciUtl ne 0 Complaint
0 Operation Review 0 Structure Evaluation 0 Technical Assistance
0 Follow up 0 Referral 0 Emergency 0 other 0 Denied Access
Oateof Visit : 1<~-17-<:?9! Arriv aiTimed/o:~AM I Oeparture T ime: ltl!tJOA-1 County: S.:~."'fso,.l Region : ,:'/Z.()
F a rm Name: IJ.,orNIP.N cW"Ie.rtJrriseS G~w;::;.,,.,.) Owner E mail: ------------
Owner Name: Ro ~+-Tit o r,.rloN ------------------------Pbooe:
Maili ng Address: -----------------------------------------------------------------
Phys ical Address: -----------------------------------------------------__ ....;_ __ _
Facili ty Contact: ~ . / 's D_ ,....,~.,•.-J.. -r"::_ I ~ Ld,...,..... ~>a,--"-Title: "~ • ..:>Pe.~' ~~~~~----------------I
Phone No: _____________ ___
Oosite Representative: ---------------------------Co hQ.Yt ~ FQ_ v~~ Integrator :--~----------------
Certifi ed Operat or:--------------------------------Operator Certification Number: ---------
Back-up Operator: ---------------------------Back-up Cer tifi cation Number:
Location of Farm: Latitude: D OD 'D " Longitude:
Di sch a rge s & S tream Impa cts
I . Is any di scharge observed fro m any part of the operation?
Di scharge o ri ginated at : 0 Struc tu re 0 Applicat io n Fie ld 0 Other
a. Was the conveyance man-made?
b . D id the di sc harge reac h waters of the State? (If yes, notify DWQ)
c. What is the es tima ted vo lum e that reac hed wa ters of the State (ga ll o ns)?
d . Does d isc harge bypass the waste managem ent system? (If yes, not ify DWQ)
2. Is th ere evid ence of a past d ischarge from any part of the ope rat ion?
3. Were th ere a ny adverse im pacts or potential adve rse impacts to the Waters of the State
oth er than from a di scharge?
D Yes ~-DNA O NE
D Yes 0 No crNA ONE
DYes D No ~A ONE
I
D Yes 0 No ~A O NE
D Yes ~ DNA O NE
D Ye s ~D N A O NE
12128/04 Continued
I Facilit)· Number: 82-6,2 (o j Date of Inspection 19 -17 -(} 91
~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 ~ DNA ONE
DYes g,;ro DNA D NE
Structure 5 Structure 6
Identifier:---------------------------------------
Spillway?: ---------------------------------------
Designed Freeboard (in): ------:----------------------------------z n ,,
Observed Freeboard (in): ---~!2'--------------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes (3-No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes [!N'O. DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers. setbacks, or compliance alternatives that need
maintenance/improvement?
DYes [3'NO DNA D NE
DYes B"N"o DNA D NE
DYes ~ DNA ONE
DYes ~DNA ONE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes ~ 0 NA D NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acce ptable Crop Window D Evidence of Wind Drift D Application Outside of Area
12. Crop type(s) _=:::&:.::..:~.....::""'-~v.....~L:: . .c...::::-=-..:(~r;::..~:.:"':..;;'~U::L,r---=.S.:::""""'-~~~~:....:G=..:...:n>..c=..!:·"'~~:=...:O::..!,~~:....:·:.:::).___,., _S=:..:..:u.:...~_tv\_;_c.v:...:...._Lf.....::W,:.:..:':..:...·~-~--~:..:.:...:.;w;.;:.:....:~::...;.s:....._ __ _
13 . Soiltype(s) BoE Wo...B. NoB. NcA
14. Do the receiving crops differ from those designated in theCA WMP? DYes ~DNA ONE
15. Does the receiving crop a nd/or land application site need improvement? DYes ~-DNA ONE
16. Did the facility fail to secure and/or operate per the irri gation design or wettable ac re determination ? DYes B"'No D NAD NE
17. Docs the facility lack adequate acreage for land application?
18. I s there a Jack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
DYes ~ DNA
DYes ~ DNA
Phone: C/IO,If$3.'333'1
Date: (/-17 -ZODCj
ONE
ONE
12128104 Continued
-l Facility Number: 8z -b¥J Date of Inspection I '1-11-() 9 I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box. 0 WUP 0 Checklists D Design D Maps D Other
DYes [31:lo DNA ONE
DYes ~ DNA ONE
21 . Does record keeping need improvement? If yes, check the appropriate box below. D Yes ~ 0 NA D NE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
-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 CA 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? (iel 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
[31qO DNA ONE
(j'Nc)" DNA ONE
[31ro DNA ONE
~DNA ONE
I3"'J'lo D NA ONE
I:3"NN DNA ONE
~DNA ONE
~DNA ONE
~DNA ONE
~DNA ONE
~DNA ONE
~DNA ONE
-. ,.... .. . '.· ~ _,...
,4l .. !flll:.t~ ~ •' . ~
12/28/04
• BI1'-'t s. 8/29/oe rr
.
-Eh"iivision of Water Quality ' I Facility Number I ?2 H tiJz.~ -,I 0 Division of Soil and Water Conservation · ·o Other Agency
Type of Visit e-eQmpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 18 -a-~ $1 Arrinl Time: I r: {10 AM. Departure Time: lto.'to ,fes I County: Stu%o,V Region: F/20
Farm Name: 7'ftorNfc,v & l!rfvt'.s¢J: W~w fi..y,......_,) Owner Email: -------------
Owner Name: gob~vf lttor~,J Phone:
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: Phone No: ________ __
Onsite Representative: ------------------Integrator: ----'C"'---'o"'--t.._· ..;;.tl-~ir-...:1:...• <--....;;;;.. ...... FC.._~v-"""---'5'-----
Certified Operator:---------------------Operator Certification Number: --------
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude: D OD'D"
· Design Current
Swine Capacity Population Wet Poultry
0 Wean to Finish
till Wean to Feeder 4410 2'10'1
10 Laver
] Feeder to Finish
0 Farrow to Wean
D Farrow to Feeder
0 Farrow to Finish
0 Gilts
0 Boars
Dry Poultry
0 Layers
D Non-Layers
0 Pullets
0 Turkeys
Other 0 Turkey Poults
0 Other ID Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Design
Capacity
Current
Population
Discharge originated at: 0 Structure 0 Application Field D Other
a. Was the conveyance man-made?
b . Did the discharge reach waters of the State? (If yes, notifY DWQ)
Design Current
Cattle Capacity Population
0 Dairy Cow
D Dairy Calf
0 Dairy Heifer
D DrvCow
D No n-Dairy
D Beef Stocker
0 Beef Fe eder
0 Beef Brood Cow
Number of Structures: []]
DYes ~ DNA ONE
DYes 0No ffNA ONE
DYes 0No ~· ONE
c. What is th e est imated vo lume that reached waters of the State (gallons)? I
d. Does discharge bypass the waste management system? (If yes, not ifY DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3 . Were there any adverse impacts or potential adve rse im pacts to the Waters of th e State
oth er than from a di sc harge?
Page I of 3
DYes 0No ~ ONE
DYes ~ DNA ONE
D Yes ~DNA ONE
12128104 Continued
I Facility Number: 8Z-f42(p I Date of Inspection 19-t'J ·"0 S I
Waste CoUection & 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 1 Structure 2 Structure 3 Structure 4
DYes ~o DNA ONE
DYes ~ DNA ONE
Structure 5 Structure 6
Identifier: _______________________________________ _
Spillway?:
Designed Freeboard (in):----------------------------------------
31 11
Observed Freeboard (in): _ ___:::::........: ___ ----------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes
(ie/ large trees, severe erosion, seepage, etc.)
S'No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed DYes i3No DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~o DNA ONE
DYes ~ DNA ONE
DYes ~DNA ONE
DYes ~ DNA O N E
II. Is there evidence of incorrect application? If yes. check the appropriate box below. DYes ~ 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn , etc.)
D PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area
13. Soil type(s) 'l?a,i? w{""g JJoA
)
NoB
I I
14. Do the receiving crops differ from those designated in theCA WMP? DYes
15. Does the receiving crop and/or land application site need improvement? DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ac re determination?O Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
DYes
DYes
~0 D NA
ifNo DNA
~ DNA
~ D NA
~ DNA
ONE
ONE
ONE
ONE
ONE
Page 2 of 3 12118104 Continued
I Facility Number: $2. -~.zdtl
Required Records & Documents
Date of Inspection 113-1.1-t!l g I
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 , chec k
the appropirate box . D WUP 0 Checklists 0 Design 0 Maps 0 Other
21 . Does record keeping need improvement? J f y es, c heck t he appropriate box below.
DYes
DYes
DNA ONE
DNA ONE
DYes ~ DNA ONE
0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysi s 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections D Monthl y and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~ DNA ONE
23 . If selected, did the fac ility fail to in stall and maintain rain breakers on irrigation equipment? DYes B'No DNA ONE
24 . Did the facility fail to calibrate waste appli cation equipment as required by the permit ? DYes ~0 DNA ONE
25 . Did the facility fail to conduct a sludge survey as required by the permit? DYes B'No 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 additional 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 £31( DNA ONE
and report the mortality rates that were hi g her than normal?
30. At the time of the inspection did the facilit y po se an odor or air quality concern ? DYes [31(o DNA ONE
If yes, contact a regional Air Quality representative immediately
3 1. Did the facility fail to notify the re gional office of emergency s ituati ons as required by DYes ~ DNA ONE
General Permit? (ie / discharge, freeboard probl ems , over appl ic ation) ~ 32. Did Reviewer/Inspector fail to discuss revi ew/inspection with an on-site representati ve? DYes DNA ONE
33. Does facility require a follow-up visit by sam e agency? DYe s ~ DNA ONE
Page3 of 3 12/28104
[Facility .Number I I)
8 Division of Water Quality / gz H bZ(g 0 Division of Soil and Water Conservation
0 Otber Agency
Type of Visit • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit IJ Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
DateofVisit: VO-tlt-P1j Arriva1Timed9:30AM DepartureTime: 1/0!IDJf,c.f I County: S..~s~A/ Region: FllO
Farm Na me: --rl'lo~l1\l tE.,JI-. rJ. Z-Owner Email: -------------
OwnerName: f<oba+ -rhtJYNioA/ _________ _ Phone:
Mailing Address: -----------------------------------____ _
Physical Address:----------------------------------------
Facility Contact: C U v/-.~ .S f.3 <i voJ i c:-lc-
Onsite Representative: ~voh'~ 'BAvwCc.;..~
Title: G""...v~ A~.,...., Phone No: --------
Integrator: (oho .,..J C.... Far;"( ..S
Certified Operator:--------------------Operator Certification Number: -------
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD 'D " Longitude: D OD'D "
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
I I 1·10 Layer
~[]~N~o~n~-L~a~y~e~r-L----L---~
ID Wean to Finish
[]Wean to Feeder
[]Dairy Cow I
I
[]Dairy Calf I
IXJ Feeder to Finish 1/._!1.10 i.l(p31_ []Dairy Hcife1
] Farrow to W can
[]Farrow to Feeder
[] Farrow to Finish
[]Gilts
[]Boars
...
Dry Poultry []Dry Cow I
[]Non -Dairy ~
I
[] Beef Stocker I
'
[] Beef Feed er I
[] Beef Brood Cov. !
. -----
0 La ye rs
[]Non-Layers
[]Pull ets
[]Turk eys
Other [] Turkey Po ults
[]Other rll·' I Number of Structures: L!...,...J ID Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of th e operation? D Yes ~N o D NA O NE
Di scharge originated at: [] Structure [] Appli cation F ield [] Other
a. Was the conveyance man-made? DYes [!1 No DNA DNE
b. Did th e discharge reach wate rs of the Stat e? (lf yes, notify DWQ) []Yes llJ No DNA [JNE
c. What is the esti mated volume that reached waters of the State (gall ons)?
d . Does di scharge bypass th e waste manage m e nt system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any pa n of the operation?
3. Were the re any adve rse impacts or potential adverse impacts to th e Waters of the State
other th an from a di scharge?
DYes ~N o
[]Yes !l9 No
[]Yes ~No
12/28104
D NA [J NE
DNA O NE
DNA ON E
Continued
I Facility Number: ~Z. -(, 2. {p I Date of Inspection Ito -DY-D11
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste le vel into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes rnNo DNA ONE
0 Yes ~No D NA ONE
Structure 5 Structure 6
Identifier:----------------------------------------
Spillway?:
Designed Freeboard (in):----------------------------------------
Observed Freeboard (in): '1.3
5. Are there any immediate threats to the integrity of any of the structure s observed? D Y cs [lJ No D NA D NE
(ie/ large trees , severe erosion, seepage, etc.)
6 . Are there structures on-site which arc not properly addressed and/or managed
through a waste management or closure plan?
0 Yes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance o r improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives tha t need
maintenance/improvem ent?
DYes ~No DNA ONE
DYes ~N o DNA ONE
0 Yes ClTNo DNA D NE
DYes ll!J No DNA 0 NE
II. Is there evidence of incorrect application? If yes, c heck the appropriate box below. 0 Yes li'3 No 0 NA D NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc .)
D PAN D PAN > 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outs ide of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s) -...JB~e:!..v..!l!M~Y.~J!o..!o.....-~.J..{.J..H~"-~j....::i~~G~YrJ.~J~<)-..L-r--~.$"l!M~Q.~t&~G..~~~i t:::!N:......~(~D~S~L)4,. ....::.SLA~7 ..::W:!.JA-~-------
13. Soil type(s) BoB N oA . Wo. B
) I
14 . Do the receiving crop s differ from those desib'llated in theCA WMP?
15. Does the receiv ing crop and/or land application site need improvement?
D Yes
D Yes
131 No DNA ONE
~No D NA ONE
16. Did th e facility fail to secure and/or operate per the inigation design or wettable acre determination?O Yes ~No DNA ONE
17. Does the facility lack adequate acreage for land appli cation?
18. Is th ere a lack of properly operating waste appli cation equipment?
DYes
D Yes
~N o
~No
D NA ONE
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):
.....
I-
--..,.
Reviewer/Inspector Name R.te:.~'"' R. (._ v e.Js Phone: Cf/0, ¢3,l'c 330D
Reviewer/Inspector Signature: K~ R~ ..JA Date: 1o -o1_-zoo7
12128104 Contmued
j Facility Number: ~2. -bzt..,j Date of Inspection [iD-bl-O 7 I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 WUP D Checklists 0 Design 0 Maps D Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes l;lJNo DNA ONE
DYes ~No DNA ONE
DYes l;lJNo DNA ONE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes Ill No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes ~No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE
Otber Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes []No DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes ~No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes !;! No DNA ONE
Additional Comments and/or Drawings: ...
1--
1-...
11128104
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
Date of Visit: IS-/t!!c o, I Arrh·al Time:I/J: tJ a!f/1 Departure Time: LI ___ ___JI Coun~·: S"eo:--pFCio..l Region: r...eo
Farm Name: -dJorAL·huv EN-f-. # Z Owner Email: ---------------
Owner Name: Kol-u . .,..-r 4 6toM k 7 l"'kodor..s Phone:
Mailing Address: ----------------------------------------------
Physical Address: ______________________ --------------------------
Facility Contact: ---------------Title: ---------------Phone No: -----------
Onsite Representatiw: -'C=.Jo!u,..d-ts ....... ~&=...~w. ... ,....,~""A::...~,_ _________ _ Integrator: __ C""""'o::::..:.../.,q""'""~;-:...!1_'~=-----------
Certified Operator:-----------------------------Operator Certification Number: --------------
Back-up Operator: --------------------------Back-up C e rtification Number:
Location of Farm: Latitude: D OD 'D" Longitude:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes ~N o D N A ONE
Discharge originated at: D Structure D Application Field 0 Ot her
a. Was the conveyance man-made?
b. Did the discharge reach waters ofthe State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gall ons)?
d. Does discharge bypass the waste management system? (If yes , no tify DWQ )
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
D Yes ()f No DNA O NE
D Yes 1;8JlN o D N A O N E
I
DYes ~N o D N A O N E
DYes ~No D N A O N E
DYes !,'j No D NA O N E
11118104 Continued
jFacility Number: <gz-62(p J Date of Insp ection 15-IO-otol
Waste Collection & Treatment
4. Is storage capacity (structural plus stoTTTI s torage plus heavy rainfall) le ss than adequate?
a. lfyes, is waste level into th e structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes 00 No D NA ONE
DYes ~No DNA ONE
Structure 5 Structure 6
Identifier: ______ -----------------------------------
Spillway'!:
/q II •
Designed Freeboard (in): __ _._ ___ ...L.-__ ----------------------------------
27 II
Observcdfreeboard(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 ~No DNA ONE
DYes ~No DNA ONE
If any of questions 4-6 were a nswered 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 Jack adequate markers as required by the peTTTiit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes
DYes
DYes
DYes
~No DNA ONE
~No DNA ONE
~No DNA ONE
~No DNA ONE
1 I. Is there evidence of incorrect application? Ifyes, check the a ppropriate box below. 0 Yes ~No 0 NA D NE
0 E xcessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc .)
0 PAN 0 PAN > 10% or 10 lbs 0 T otal Phos phorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Appli cation Outs ide of Are a
12. Crop type(s) B~f"'etud~.. IIQ? . JY""/ G,.4 ,y . .5f,-,., ....... f t./1 #f-o-#PA'!.c:!l.& kJ?>t,li.-~c... ;; > >
13. Soil type(s) Necfi.ik Wa.~nz""> 8/...,.ffi.tJ
I I
14. Do the rece iving crops differ from those designated in the CA WM P?
15 . Does the receiving crop and/or land application site need improvement?
DYes
DYes
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable acre deteTTTiination ':D Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
DYes
DYes
[!No DNA
~N o DNA
fENo DNA
l8 No DNA
rgiNo DNA
ONE
ONE
ONE
ONE
ONE
I Facility Number: <?2. -6z.G,j Date of Inspection 1>-l"o-owl
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 theCA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists D Design D Maps D Other
DYes ~No DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No DNA D NE
D Waste Application 0 Weekly Freeboard 0 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 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes agNo DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes rnNo DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes {2gNo DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes 0No ~NA 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 0No ~NA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance ofthe permit or CAWMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes i:l 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
If yes, contact a regional Air Quality representative immediately
IE No DNA ONE
31. Did the facility fail to notify the regional office of emergency situations as required by DYes QgNo DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE
12128104
Type of Visit G Compliance Inspection
Reason for Visit 0 Routine 0 Complaint
0 Operation Review 0 Structure Evaluation 0 Technical Assistance
0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Dateof\'isit: I JP: ·g I ArrivaiTime:IJo : ~ ~-I Departur e Time: L.I ___ -.....JI County: ..Seep.s~e Region: F IZ-o
3/IS/ o .-:r
F "' ....,-I -f ~ arm l'•a me: --.:...'....!: •b;J.O.,,..,.c.·AJ""""r...~u....___.f:r.....e.._.e.L.<"'--"c~f::..:-~ ... l:J....,s: ... ~~..J4'-'''--------Owner Email: --------------
Owner Name: A oh-< ,.~ a.r-..& Srpr., 14.1 lha.,."' t ... e
Mailing Address: 3~-d. 5c .... t\... m LC....c..Ht:n J<..R..
Phone:
Physical Address: ---"Q...!...: ..... ~__:C~aa..o->~c.~y--LB~d<Z!.... ________ --------------------
\
Facility Contact: ______________ Title:-----------Phone No:------------
Onsite Representative: _.::C::... ... :::...::::o.~· ... '-"at--.~\L-.r:bloJ,O.>z.'"..~~:n .... -\:J...lil.oV'\!:1..... ______ _
\ Integrator: __ C=.!::.o...:"':..!.-:::a::...."!...,.:..' .::::<-=-----------
Certified Operator: __ .:.C<!...ll:r~o.a..\.~c."\-----"'Ihn ... o ~o ..... \
Operator Certification Number: I'-7 S I
Back-up Operator: --------------------Back-up Ce rtification Number:
Location of Farm: Latitude: D OD'D" Longitude: D OD'D "
Design Current
Capacity Population
Design Current
Capacity Population Swine Cattle Wet Poultry
Design Cu-rrent
Capacity Population·
ID Wean to Finish
0 Wean to Feeder
00 Feeder to Finish l./ '11 (> 4./l.l.~
0 Farrow to Wean
0 Farrow to Feeder
0 Farrow to Finish
0 Gilts
0 Boars
·-· . --.. -
0 Da irvCow I
0 DairvCalf .
0 Dairy Heifet I
I
0 DrvCow I I
0 Non-Da irv
0 Beef Stocket
0 Beef Feeder
0 Beef Brood Cow ! . -.. .•. ~-
I I I 10 Layer I I
Dry Poultry
0 La yers
0 Non -Lavers
0 Pullets
0 Turkeys
Other 0 Turkey Poult s
0 Other IQ 9ther Number of Structures: OJ !
Discha rges & Stream Impacts
I . Is any discharge observed from any part of th e opera tio n? DYes [l!No D NA O NE
Discharge originated at: 0 Structure 0 Application Field 0 Other
a. Was the conveyance man-mad e? D Yes 0No DNA ONE
b. Did the disc ha rge reach waters ofthe State? (If yes, notify DWQ) DYes 0 No D NA ONE
c . W hat is the estimated volu me th at reached waters of the State (ga ll ons)?
d . Docs di sc ha rge bypas s the waste management system? (If yes. not ify DWQ)
2. Is there evidence of a past di scharge from any part of the operation?
3. Were there any adverse impa cts or potential adverse impacts to th e Waters of the Sta te
other th an from a di sc harge?
DYes 0 No
D Yes ~No
DYes 00 No
12128/04
D NA O NE
D NA ONE
DNA ONE
Continued
I Facility Number: XJ -~ ,2(. [)ate of Inspection I31JS" Jt:>..S I
\Vaste 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 [il No DNA ONE
DYes DNo DNA ONE
Structure 5 Structure 6
Identifier: _ _:..M:;,.;.;:<!!::.;IV::::;..../'-·-----------------------------------
Spillway?:
I . 9 ,,
Designed Freeboard (in):--"-=-----(,.-7-fs' ------------------------
Observed Freeboard (in): _...,~,)c:...::9=--'' ___ ------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes ~No DNA ONE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed DYes 00No DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits , dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
@Yes 0No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes reNo DNA ONE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes lXI No 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 0 Application Outside of Area
12. Croptype(s) Ge.,..M...k ;c•q.cd?
1
bee....._, &c.. Le 1J IAJ~J ~j(J.) ~~ Q:J <a-)s;s;c.P...
13. Soil type(s) /'-lod·11k Ia lnlcAXh. 12.\a...-.t ct:) 1 ;
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 00No DNA ONE
DYes liJNo DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination!D Yes OCI No 0 NA 0 NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
DYes ~No DNA ONE
0 Yes [ijNo DNA ONE
·"' • • ~ J,; -~--~ • ;;-• ••• -~ .. ... -•
·Comments (refer ~ q'uestion #): Explain any YES answers and/or any recommendations ·or any otbe~ romments:. .
Use drawings offacility 't~ better explain. situations. (use add.iti~nal pages as necessary):. . ,,
)f J'i" f ~ }r F, c!!..-\ ..l
clP t'lo~ QfPI'"1
No· d. h ... , a.. """''' \.,...
"'"'(L.4~~ w'.+-\...'-"' \OO 1
+\...<-c..ov--.<r
c.(.. vc.\l,
Reviewer/Inspector Name r.-J ~ v ... · L... /},...,. Jt:.... · I Phone: &) /0 'I J.t lfY / ~_.~~~--~~~~--~~~--~--~----~
Reviewer/Inspector Signature: ~~ )1 __ ,;.., Date: 3ff f" /i:Jf'""
...
/ 7 11128104 Continued
I Facility Number: 8'.). -{,)t. I Date oflnspection 1.3.//S"/o~-i
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes 00No DNA ONE
DYes [X!No DNA ONE
00 Yes 0 No 0 NA 0 NE
D Waste Application D Weekly Freeboard D Waste Analysis 00 Soil Analysis 0 Waste Transfers D Annual Certification
D Rainfall D Stocking ~Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
Addi,tio.i·al Comments and/or Drawi.Ogs:·
5o·,\
'-\ -~ .... :~ .
DYes
DYes
DYes
DYes
DYes
00No
[i)No
(jl No
[j}No
l5i] No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DYes 0 No DNA [il..NE
DYes liJNo DNA ONE
DYes 1;&1 No DNA ONE
DYes I:BNo DNA ONE
DYes (j!No DNA ONE
DYes []No DNA ONE
DYes !:¥No DNA ONE
p \Q.DL ~ "-' ~~ '"' +u \(. <-c.f c_,.c. ~ '/\d.~.. c.."' ('. f f.-v ·J<...Jl ~.,._.~ . yY\. Y.
12128104
f
IQo"'~,.,nnli,.nr·<> Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ~e 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access
Facility Nuinber g-a H t;~' I Date or Visit: I 01 b;klll Time: IJo: IJO
. lo Not Operational 0 Below Threshold
urPermitted ~rtified C Conditionally Certified C Regis'red Date Last Operated or Above Threshold: -----------------
Fann Name: ::fhd~----l~f.ri_~-----lf:~-------~~-"&.-~.}.......... County: ... 2~~~---·-···--··------·-··--·--·-···--·
:: NA-::.,~f.f!fJJi.!-~~r_t ·---;·-·--~~-·----·--·---I:~::• N;t-~~;~~~?JD ·-------·
g ···········---------··S. ..... Af..~t! .. lc.!L ................................................ C -·--·-·+·--·-·--·-·-········----·-·-···-·--·-·-·--·· ··--·-·--·-···
Fa<ility Conoact' ___ ..c_!"~::z&~':!!.'::!. _______ TIO" ··--·---------·-·--71, 0Pho~e No' -:----------··
Onsite Representative: .&.~s._ __ ~;. _____________________ ··-·-·------·--·· Integrator: ... ~M·c.·:. . .Ji~~------------== ~:;::,"·-t_~-~~0'-\.______________________ Operator Cerlffi<aOonNumber'---·------·--
0 Poultry D Cattle 0 Horse Latitude .._ _ _.1•1~-. _---Jj' ~...1 __ ..... 1" Longitude
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at D Lagoon D Spray Field D Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse 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? D Spillway
Structure I Structure 2 Strucmre 3 Structure 4
Identifier:
Freeboard (inches): _ ____.ja;;.....~L----
12112103
Structure 5
DYes ~
DYes DNo
DYes DNo
DYes DNo
DYes ~
DYes ~
DYes ~
Structure 6
Continued
'
~ 1
(_FacJ,-ty-,N-u-m-be-r:-f=-~--""7,...,~,..,..(,--. Date of Inspection l3~.;t/o'fl
5. Are there any immediate threats to the integrity of any of the structures observed? (ieJ 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 environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any pan of the waste management system other than waste structures require maintenance/improvement?
9. Do any sructures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenanceiimprovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
D Excessive Ponding D PAN D Hydraulic Overload D Frozen Ground D Copper and/or Zinc
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
12. Crop type &r,.,,.l,_
~--~~~~~~~~~~~~-=~~~------------------------------------~ 13. Do the receiving crops differ with tho designated in the Certified Animal Waste Management Plan (CA WMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
liquid level oflagoon 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.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
12112103
DYes
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes
DYes
DYes
DYes
Date of Inspection l=st#~/6&f I
Required Records & Document.o;
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?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
D Stocking Form D Crop Yield Form 0 Rainfall D Inspection After I" Rain
j:l120 Minute Inspections 0 Annual Certification Form
DYes ~
DYes [!)1(o
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~ DYes
~s ONo
erYes ONo
DYes ~
DYes ~
~ONo
DYes~
liD"" No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
/lit-. 11--... J... j*t ~ • .. ..., ~I ~-J ~~ ; .. l't r-" . f f"''tt)
r~.... ~tro. ~J ~;"") ~t a-/; L~~J.
12112/03
• f--
General Infonnatioo:
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
Date: r2j; 2 /CJ (e I
Time: /()~3 eq
FannName: =ne9~1o"' ~ V'\-t-vrl·~ s. County: . .S~p~crt
Owner Name: B~ '-•C'l--\'c:.. \S..r a .m~ T~ ~ -\-c \A_ Phone No: ·s-"3. 3 -3 I 7 4
On Site Represen~ ' (', 1 r-fi s.~ B c._rt.,..._),· c. K lntegrator:.--~o.C_.cu· b&-~....:.,·.30e....::;..._ ______ _
Mailing Address: 3 5~ SR '<'~ ffic (.. . ~ 9.& 11 • •
~'MI ,..._jc__ Js~Z,_}?
Physical Address/Location: 5 .rvvk ~ o ~ Y\o. o+. CJJ.01A
Latitude: '!:> S: I 0'1 I S 8 Longitude: 7 8 I I fD I O'f
Operation Description: (based on design characteristics)
TYPe of Swine No. of Animl1ls
OSow
){Nursery
OFecckr
OtherType ofliwmock: f,",,is ~.:1~ 'i 1../t..f'-1
v
Type of Pollhry No. of ArUrnDJs
Olayer
(J Non-Layer
Number of AnimtU.r: 4 t/ '14
Type of C4trle
OI>airy
OBeef
No. of AnimtU.r
Number of Lagoons: :;_ (include in tbe Drawings and Observadons the freeboard of eacb lagoon)
Facility Inspection:
Lagoon
. .
Is lagoon(s) freeboard Jess than 1 foot+ 25 year 24 hour_ stonn storage?:
_Is seepage observed from the_ lagoon?:
Is erosion obselved?:
Is any discharge observed?
0 Mtu~-miJ/k 0 Not MQil-mmle
Cover Crop
Does the facility need more acreage for spraying?:
Does the cover ~rop need improvement?:
( li.rr the crops which ued improvemettt)
YesD No~
Yes 0 No)2f'
YesD N~
YesD NoS'
YesQ No~
YesCl No~
Crop type: £; e, J A~:. ________ _
Co ~-.~ f
Setback CriUrill ..
Is a dwelling located withiri 200 feet of waste application?
Is a well located within 100 feet of waste application?
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream?
YesD
YesD
·"' . .r 0 ·.,.· Yes
••. II
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream? ·. YesD
AOI-January 17,1996
r --~------~~u~~~~~
Does the facility maintenance need improvement?
Is there evidence of past discharge from any part of the operation?
Does record keeping need improvement?
Did the facility fail to have a copy of the Animal Waste Management Plan on site?
YesQ No~
YesQ No~
YesQ N~
YesO NO"tr
Explain any Yes answeiS:. _________________________ _
Signature:
cc: Facility Assusmelll Unit
DrawinKS or Observations:
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AOI-JanuarJ 17.1996
Use Atttldunenu if Needd