HomeMy WebLinkAbout820630_INSPECTIONS_20171231NORTH CAROLINA
Department of Environmental Quality
Date of Visit: 1900\ l1a.t J £ DepartureTime:j-§';l·sf?tcounty:S~e;k/ Region: £rW
F N ~"' ·( ,-.J .~ arm arne: __, c.-<-!\. c.,_ _ ;z:::. c.. Owner Email:
OwnerName: ~[)~&~.~~--~~~~---S~~-~-(~~~~~~-~~--Phone:
Mailing Address:
Physical Address:
Facility Contact: ~ f3~~ t(f{ Title: --------~----~~~--~-----Phone:
Onsite Representative; l ( Integrator: l'Vt if S'
Certified Operator: 0, c3r ~Ti?.tckt.ANO --~~----~----~----~=------------Certification Number: L <( Z. Z/ f
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure D Application Field
a. Was the conveyance man-made?
0 Other:
b. Did the discharge reach waters of the State? (If yes, notifY DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
Certification Number:
Longitude:
DYes~
DYes 0No
DYes 0No
d. Does the discharge bypass the waste management system? (If yes, notifY DWR) DYes 0No
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
0 Yes [J1'1o
DYes ~0
DNA ONE
~A ONE
c:r'NA ONE
ifNA ONE
DNA ONE
DNA ONE
21412015 Continued
I Facility Number: £:$ Z: -' 3 0
Waste Coll~tion & Treatment
I nate of Inspection: L( 1£(1/o
4. Is st9~age capacity (structural plus storm storage plus heavy rainfall} less than adequate? ,_
a. If yes. is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~NA ONE
D Yes 0 No ~O NE
Structure 5 S tructure 6
DYe s ~ D NA ONE
0 Yes ~o 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 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 requi re
maintenance or improvement?
Waste Application
10. Arc there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
II. Is there evidence of incorrect land application? If yes, check the appropriate box below .
QYes ~ DNA ONE
0 Yes ~o 0 NA 0 NE
D Yes ~ DNA ONE
DYes am DNA ONE
0 Yes ~ 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Meta ls (Cu, Zn , etc .)
0 PAN 0 PAN> 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorp orate Manure/S ludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 App licati on Outs ide o f Approv ed Area
12. Crop Type(s): l2(3 3&-V
13. Soil Type(s): Cc
14. Do the receiving crops di fTer from those desih>nated in the CAW M P'!
15. Does the receiving crop and/or land application site need improvement?
16. Dicl the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility Jack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components ofthe CAWMP readily available? 1f yes, check
the appropriate box.
Owup 0Checklists D Design 0 Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes. check the appropriate box below.
0 Yes ~DNA ONE
0 Yes ~DNA ONE
0 Yes ~ DNA ONE
0 Yes ~ DNA ONE
0 Yes ~ DNA ONE
0 Yes c;rNo DNA O N E
0 Yes ~ DNA O N E
D o t her:
0 Yes ~D N A O NE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Anal ys is D Waste Tra ns fers 0 Weath e r Code
0 Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections 0 Monthl y and 1" Rainfall In spect ions D Sl udg e 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 ?
Page 2 of3
0 Yes [A'No 0 N A 0 NE
D Yes CfNo 0 N A 0 NE
21412015 Continued
!Facility Number: !3 ;;;(_ ~ J 0 I !nate of Inspection: !-/ /1?, /B I
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes ~ DNA 0 NE
25. Is the facility out of compliance with permit conditions related to sludge? Ifyes, check 0 Yes ~DNA 0 NE
the appropriate box(es) below.
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge level s
J,l 0 Non-compliant sludge levels in any lagoon
List structure(s) and date of frrst survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field D Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the pennit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representati ve?
34. Does the facility require a follow-up visit by the same agency?
0 Yes
0 Yes
0 Yes
DYes
0 Yes
0 Yes
0 Yes
0 Yes
0 Yes
~DNA
~NA
~DNA
~DNA
~ DNA
~ DNA
~ DNA
~DNA
[;3-Ne 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).
j/-1°-17
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/Inspector Name: Phon/f/IJL t{ 3 3 ~ 6 j 3 Y
Date: ~{ 1'1("7 / f>
21412015
T ype of Visit : . 'l;~liance Inspection Operation Review 0 Structure Enluation 0 Technical Assistance
Reason for Visit : '(j Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 De ni ed Access
DateofVisit:117J\i(II{1Arri\'aiTime:l troA DepartureTime:tf!.3sA !c ounty : sJ]vM Region:
Farm Name: .:TI4\.~ ~~ I rJZ
Owner Name:
Mailing Address :
Physical Address:
Facilit~' Contact:
Onsite Represent a ti\'e:
. Certified Operator: K
Owner Email:
Phone:
Phone:
Integrator: ·~t lJ >-S'
Certification Number: q {-1__1J f
Certification Number : · Back-up Operator: --------------------
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is a ny d ischarge o b served from any part of the o pera ti on?
Di sc harge ori g in ated at : D Struc ture . 0 Ap pli cat ion Fiel d 0 Othe r:
a. Was the conveya nce ma n-made?
b. Did the discharge reach wat ers of th~ Stat e? (If yes. no t ify DWR )
c. What is the est imated volume that reached waters of the Sta te (gall o ns)'!
d. Docs the disc harge bypass the wa ste management syste m? (I f yes, noti fY DWR )
2. Is the re evi dence of a pa st discharge from any part of the opera ti o n?
3. We re th e re any obser va ble adverse impacts or potential adve rse imp ac ts to the waters
of th e Stat e oth er tha n from a discharge?
Page I of 3
Longit ud e:
0 Yes ~D N A O N E
0 Yes 0 No ~A O NE
0 Yes 0 No ~A O NE
0 Yes 0 No ~A O NE
D Yes 0'8o DNA O NE
0 Yes ~0 DNA O NE
21412015 Contim1 ed
I Facility Number: f'}...-h 3 D I nate of Inspection: 171/}j f11
,Vaste Collection & Treatment DYes ~0 . DNA
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? LJ No 0 NE
a. If yes, is waste level into the structural freeboard? 0 Yes 0 No []'1fA 0 NE
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 23
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?
Structure 5 Structure 6
DYes ~o DNA ONE
DYes ~o 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. Docs 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?
ll. Is there evidence of incorrect land application? If yes, check the appropriate box bel ow.
DYes ~o
0 Yes r:(No
DNA ONE
DNA ONE
DYes~ DNA ONE
D Yes [;f'No DNA D NE
DYes ~o DNA ONE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
13~ 86'0 12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in theCA WMP?
15. Docs the receiving crop and/or land application site need improvement?
I 6. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Docs the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
0 Yes !£?'No DNA
0 Yes ji&'No DNA
0 Yes ~0 DNA
0 Yes [2J"No DNA
0 Yes [2(No DNA
ONE
ONE
ONE
ONE
ONE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 0 Yes [2fNo 0 NA 0 NE
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check 0 Yes !Zf'No 0 NA 0 NE
the appropriate box.
0WUP 0Checklists Ooesil:,'ll 0 Maps 0 Lease Ah'Teements 00ther: _________ _
21. Docs record keeping need improvement? lfyes, check the appropriate box below. D Yes Cd"No DNA 0 NE
0 Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers D Weather Code
0 Rainfall D 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? D Yes IC:f No DNA 0 NE
23. If selected , did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes E:{No DNA 0 NE
Page2of3 21412015 Continued
I Facility Number: I Date oflnspection: -£1
.Z4. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes
DYes
~0
[g'No
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
2 7. Did the facility fai I to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
lfyes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notifY the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? lfyes, check the appropriate box below.
0 Application Field D Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
DYes E::("No
0 Yes c::fNo
DYes ~o
DYes ~o
0 Yes [A'No
DYes ~o
DYes
DYes
DYes
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
c6{Jl6~-~V\ c:. e:r-f-Ib
5f~-e-~ t'J.--J.-b-16 -"f:OJ-3 P·'f.t
~ 'b-J..,? P· ~, 1
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Pagel of3
Phone:~fO .. i(J3 :3 33'f
Date: d-7 ~{ 11
214/2015
Lo~liance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ef"Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: O..U::'f=::....:...-4rf'! Arrival Time:I/J a;z pI Departure Time:l/~tfif? I County: g,f-u<.__ Region: %
r:s:. "'-..l... -~~5 .::tJ::l ~ Owner Email: Farm Name:
Owner Name: Oa.J..A-~;'(---& s+.tt-JlJ ~~
Mailing Address:
Physical Address:
Facility Contact: ~O.:....:.....~--~......J--~$...=.!::....~-f4v_ Title:
Onsite Representative: v{
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field
a. Was the conveyance man-made?
Phone:
D Other:
b. Did the discharge reach waters ofthe State? (If yes, notifY DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
DYes ~A ONE
DYes 0No ~A ONE
DYes 0No ~A ONE
d. Does the discharge bypass the waste management system? (If yes, notifY DWR) DYes 0No c;;rNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes
0 Yes
I
~ DNA ONE
No DNA ONE
21411015 Continued
r !Facilit}"Number:
Waste Collection & Treatment
!Date of Inspection: g: '?'& ~ t6 I
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): .1] .?JS'
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~NA ONE
DYes 0No ~ ONE
Structure 5 Structure 6
DYes ~DNA ONE
DYes ~ DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any ofthe structures need maintenance or improvement? 0 Yes ~o DNA 0 NE
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part 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 Q-MO 0 NA 0 NE
DYes ~o DNA ONE
DYes DNA ONE
II. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. 0 Yes DNA ONE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs. 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): ~e'~ ~rov
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 detennination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? 1fyes, check
the appropriate box.
DYes ~0 DNA
DYes (3No DNA
DYes [2J'No DNA
DYes IZfNo DNA
DYes [LfNo DNA
DYes [Z(No DNA
DYes E:]No DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
0WUP Ochecklists 0Design D Maps D Lease Agreements OOther: __ ~,~------
21. Does record keeping need improvement? Ifyes, check the appropriate box below. D Yes ~No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and In Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~No 0 NA D NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? D Yes IZJ No 0 NA D NE
Page2of3 214/2015 Continued
I facility.Number: I nate of Inspection: CJD
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes ~ DNA
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes ~ DNA
the appropriate box( es) below.
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date offrrst survey indicating non-compliance:
[i(N: 26. Did the facility fail provide documentation of an actively certified operator in charge? 0 Yes DNA
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? 0 Yes ~ DNA
Other Issues ~ 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 0 Yes 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? 0 Yes ~0 DNA
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notifY the Regional Office of emergency situations as required by the DYes ~ DNA
permit? (i.e., discharge, freeboard problems, over-application) cr:a 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes 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 ~No DNA
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes [LI"No DNA
34. Does the facility require a follow-up visit by the same agency? DYes @No DNA
Comments (refer to question#): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
C~G.V'v{~ il-'3 -ty
S~L~4 ~ ~( O·
~z--o·
ONE
ONE
ONE
ONE
ONE
ONE
ONE
O NE
ONE
ONE
O NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
Phone: V\'9 ~ 1l})J
Date: ·~f\~
21412015
ompliance Inspection Operation Review 0 Structure Evaluation
Reason for Visit: ~utine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Denied Access
Date of Visit: WC=!£[ Arrival Time:[ ?7.:> 0 [ Departure Time:[ /t' ( t>O [ County:__z:'~,-_ Region: ~1)
"(/;y1~ £?07!) J rJ:= -#:2, Owner Email: Farm Name:
Owner Name: Van.:<! :£c?f6 .fTCi~fd Phone:
Mailing Address:
Physical Address: ---------------------:~f-J~--r---------------------
Facility Contact: ~6--r....::;...-'--""'c-'-r'--t/-....:.ln....;.....;_o_o_~ ____ Title: _,.,d.'-L-"'-'r.'"""£"":....::._"'"""""'~"""/.~....::~:........::c:......:....' __ Phone:
Onsite Representative: Integrator: .Lg~·~r:::~---------
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? 0 Yes 0-No DNA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other:
a. Was the conveyance man-made? DYes 0No DNA ONE
b. Did the discharge reach waters of the State? (If yes, notify DWR) DYes 0No 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 DWR) DYes DNo DNA ONE
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes
DYes
~No DNA ONE
[29..No DNA ONE
214/2014 Continued
l •
!Facility Number: I Date of Inspection: ,//-2-1 s-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in): ;CJ-/'7
Observed Freeboard (in): 30
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 C8J'Jo DNA 0 NE
DYes 0 No 0 NA 0 NE
Structure 5 Structure 6
D Yes ~No 0 NA 0 NE
D 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 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. Arc there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes .BJ No DNA ONE
DYes ~No DNA ONE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes J;a_ No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Type(s): 2crat~.(~~ /a~.,..../
13. Soil Type(s): J3 op / w~
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 desihrn 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 ofthe CAWMP readily available? If yes , check
the appropriate box.
Dwur 0Checklists 0Design D Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes 0No DNA ONE
DYes 12!-No DNA ONE
DYes ~No DNA ONE
DYes ®No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
Oother:
DYes ®No DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers 0 Weather Code
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~No 0 NA 0 NE
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~N o DNA 0 NE
Page2of3 21412014 Continued
• lFaciUty Number: lDate of Inspection: /~-2-J£
•
'
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box( es) below.
DYes 1;6No
DYes jQiNo
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below .
0 Application Field 0 Lagoon/Storage Pond 0 Other:
0 Yes (&No DNA 0 NE
0 Yes [81 No 0 NA 0 NE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
------------------------
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
0 Yes lZJ No 0 NA 0 NE
D Yes EJ No D NA 0 NE
DYes g}_No 0 NA 0 NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings o{facility to better explain sirnatioos (use additional pages as necessary).
).)crl-r-,1 roflow i rr:Jd,~~ fJc.s~
XY t-u-rd.!> f-.....-C/; y(..if-rj ~ I ;l -'t -,?Lo6'
Reviewerllnspecror Name :
Revie wer/Inspector S ignature :
Page 3 oj3
Phone: /'-/0-¥-JJ-:rro c
Date : //--..,7-;2¢ 1£
214/2014
Reason for Visit:
Date of Visit: I/ o--;?flql Arrival Time: l?f Ot>
:r ~ -:#=-
Farm Name: \!tans Fiu=mj / ._J-k
Departure Time: I/ b ~ Q Q I County: $7 <iT'-Region: EE 0
Owner Email:
Owner Name: Da..KI A Ba -1-tJ , 5"7Ci c..A J ~J Phone:
Mailing Address:
Physical Address: ---------------------:------------------------
__.,G......_·.._(".,;;,r"_...-:....:...r_· .... Jn~oo~r-c_---==----Title: --L.d...:......;..4"'l;;;.JJt:;.;.... ............ ~~~;....:.....;~;;..._·_ Facility Contact:
Onsite Representative:
Certified Operator: .... D""""'_.a:;:;L,L<a"---S""""'--'I_,c.........,i· c"'-'-k.:.....L.J..;;;.~_-,J....;;.,...__ _____ _
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I . Is any discharge observed from an y part of the operation?
Phone:
Integrator: Jn,1 '}'~ fie~~
Certification Number: 9Y~j Y
Certification Number:
Longitude:
DYes a_No DNA ONE
Discharge originated at: D Structure D Application Field D Other:'
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c . What is the estimated volume that reached waters of the State (gallons)?
d . Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part o f 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
DYes
DYes
DYes
0No DNA ONE
0No DNA ONE
0No DNA ONE
~No DNA ONE
~No DNA ONE
114/2014 Continued
!Facility Number: IDate oflnspection: / t:)-,;11-lq I
Waste Collection & Treatment
4. Is stora ge 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: rnJ-73aJ
Spillway?:
Designed Freeboard (in): tcr Lq
Observed Freeboard (in): j l a!:~
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?
0 Yes j2g No 0 NA 0 NE
0 Yes D No D NA 0 NE
Structure 5 Structure 6
___ \\.
0 Yes ~No 0 NA D NE
0 Yes ~No DNA D NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify 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 s tacks)
9 . Does any part of the waste management system other than the waste structures requ ire
maintenance or improvement?
Waste Application
I 0. Arc there any required buffers, setbacks, or compliance alternat ives that need
maintenance or improvement?
DYes ~No DNA ONE
0 Yes ~No 0 N A D NE
DYes ~No QNA O NE
0 Yes ~ No 0 NA 0 NE
11. Is th ere evidence of incorrect land application ? lf yes , check the appropriate box bel ow. 0 Yes ~ No 0 NA 0 NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn , etc.)
D PAN 0 PAN> 10% or 10 lbs . D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Are.a
I2.CropType(s): 8-el'/l!w/1!-/o"r-r'{"Y',_/
13. Soil Type(s): Jn:& J G !C,
14. Do the rece ivi ng crops differ from those des ign ated in th eCA WMP?
15. Do es the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per th e irrig ation design or wettable
acres determination?
17. Does th e fa cility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box .
owuP O chccklists D De sign 0 Maps D Lease Agreements
21. Do cs record keeping need improvement? If yes, check the appropriate box below.
DYes ~No DNA ONE
0 Yes ~No DNA ONE
0 Yes 5l.No DNA ONE
DYes .lKJNo DNA ONE
0 Yes ~No DNA ONE
0 Yes (gi No DNA O NE
0 Yes ~No DNA O NE
0 0ther :
DYes ~No DNA ONE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analys is 0 Wa ste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute In spections 0 Monthly and 1" Rainfall In spections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? D Y cs [;8 No 0 NA 0 NE
23. If selected, did the facility fail to install and maint ain rainbrcakers on irrigation equipment? 0 Yes ~No 0 NA D NE
Puge1of3 11412014 Continued
I Facility Number: I nate of Inspection: Ia-der ll{
, 24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? lfyes, check
the appropriate box(es) below.
D Yes ~No D NA D NE
D Yes ~No D NA D NE
0 Failure to complete annual sludge swvey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first swvey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
DYes ~No DNA ONE
D Yes g;J No D NA D NE
D Yes ~No D NA 0 NE
DYes ~No DNA ONE
DYes ~o DNA ONE
D Yes (R No DNA D NE
D Application Field D Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
DYes ~No DNA ONE
D Yes Da. No D NA D NE
DYes ~o 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).
Revi ew er/Inspector Name: Sa~~
Revie wer/I nspector Signature : ----...,:;i.~;i;=-/-~...::;,..~p. _____ · -----------------------------
Page3 ofJ
Phone: cz-ltci(IJ-' 1Ja>
Date : /0 --;?? -/4
214/2014
ompliance Inspection Operation Review 0 Structure Evaluation
Reason for Visit: ~utine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Denied Access
Date of Visit: l/ () -.J:Y-8 I Arrival Time: 19 .' J ~ I Departure Time: I /;2! :JD I County: .ry-ca
Va # ~ Farm Name: ~na Farm~ / rJ-: t?-: Owner Email:
.s
Region: F"R.. 0
Pbone:
Mailing Address:
Physical Address: -------------------------------------------
Facility Contact: ~G~t....:r....!~"-L.,C_...:.hf....:..._O:::.:P:::....:....r-z:..!::.... ___ Title: d~ ¥r=v-Phone:
Int"llnllo" ./hv&
Certification Number:
Onsite Representative:
Certified Operator: 1tciJ:/~
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I. Is any discharge observed fi-om any part of the operation? 0 Yes f5.l.No
Discharge originated at: D Structure 0 Application Field 0 Other:
a. Was the conveyance man-made? DYes 0No
b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No
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 0No
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes ~No
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21412011 Continued
I Pacility Number: l Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure) Structure 4
Identifier: fd.f!t!:,,-£-,~ .. ,
Spillway?:
Designed Freeboard (in): tq A
Observed Freeboard (in): ,;ll ~'i
5. Are there any immediate threats to the inte1,rrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
D Yes 0 No 0 NA 0 NE
Structure 5 Structure 6
D Yes ~ No 0 NA 0 NE
DYes j&No 0 NA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9 . Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10 . Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
D Yes ~No 0 NA 0 NE
DYes (B_No 0 NA 0 NE
0 Yes ~No 0 NA 0 NE
DYes C8..No 0 NA 0 NE
II . Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Y cs 5a_ No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Gro und 0 Heavy Metals (Cu, Zn , etc.)
0 PAN 0 PAN > 10% or 10 lbs. D Total Phosphorus 0 Failure to In corporate 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): 15-c::lfHJ«-/ov-r-ra~e.-J
13. Soil Type(s): 73 0 E I a-rc-
14 . Do the receiving crops differ from those designated in the CA WMP?
15 . Does the receiving crop and/or land application site n eed improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility la ck 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 th e Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
DYes ~No DNA O NE
DYes ~N o DNA ONE
DYes ~N o DNA ONE
0 Yes I:Bi.No DNA ONE
0 Yes ~No DNA ONE
0 Yes ~No DNA ONE
DYes ~No DNA ONE
OWUP O checklists 0 Design 0 Maps 0 Lease Agreements 00ther: _________ _
2 I. Does record keeping need improvement? If yes, check th e appropriate box below. 0 Yes ~ No 0 N A 0 NE
0 Waste Application 0 W eekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and I" Rainfalllnspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to ins tall and maintain rain breakers on irrig ation equipment?
Pagelof3
DYes ~N o DNA O NE
0 Yes ~ No D NA 0 NE
214!101 1 Continued
!Facility Number: loate oflnspection: /0-7J. 3-L5 -1
24. Did the facility fail to calibrate waste application equipment as requ ired by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes ~No DNA ONE
DYes ~o DNA ONE
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
Li st structure(s) and date of first survey indicating non-compliance :
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to sec ure a phosphorus loss assess ments (PLAT) certification?
Otber Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours a nd/or document
and repo rt mortality rates th a t 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)
O Yes g) No
DYes ~No
DNA ONE
DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below .
0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
0 Yes f25t,N o
DYes ~No
0 Yes [81..No
D NA ONE
DNA ONE
DNA ONE
Comments (refer to question#): Explain any YES answers and/or any additional recommendations or any other comments.
U~e drawings offacility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signa ture :
Page3 of3
Phone : ~ -7'3'J-~.) 00
Date: g;-;>::5 --l-CJ {..)>
214/101 I
Reason for Visit: 0 Other
Date of Visit: 1/1-/'--121-Arrival Time: I // oV I Departure Time: liD: ou I County;,_S'~~ Region: ~ 0
Farm Name: ~ &on~
Owner Name: J2et.t1 a Z, ~
Mailing Address:
t:2= Owner Email:
.£T'r"l c..k { J Phone:
PhysicalAddr~s : --------------------------------------------------------------------------------------
Facility Contact: Phone:
Onsite Representative: _..2."""'"...:4-Y?'-='""""'-=--------------------------Integrator: ------------------------
Certified Operator: _Q."""""a..... ... · =o.a...:...._"ft~~:;z...j~---------------------------Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from a ny part of the operation? DYes ~N o DNA ONE
Di sc harge originated at : D Structure 0 Application Field 0 Other:
a. Was the conveyance man-made? DYes 0No DNA ONE
b. Did th e di sc harge reach waters of the State? (lfyes, notify DWQ) D Yes 0No DNA ONE
c. What is the estimated volume tha t reached waters of the State (gall ons)?
d. Does the di sc harge bypass the waste man agement system? (If yes, notify DWQ) DYes 0No DNA ONE
2. ls there evidence of a past d ischarge from any part of the operation?
3. Were there any observable advers e impacts or potential adverse impacts to the waters
of the State other than from a di sc harge?
Page I of3
DYes ~No
0 Yes [gJ.No
D NA ONE
DNA ONE
1/412011 Continued
I Facility Number: I Date of Inspection: J/-16-fb I
Waste Collection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: 1.)..~ L-vwr!'r
Spillway?:
Designed Freeboard (in): J9t l<J:.
Observed Freeboard (in): Jf=fC_ ~;z
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e .• large trees, severe erosion , seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
DYes D No DNA D NE
Structure 5 Structure 6
DYes ~No DNA ONE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the pcnnit'?
(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 butTers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~o DNA ONE
DYes [&_No 0 NA 0 NE
0 Yes !g) No 0 NA 0 NE
DYes 18l.No 0 NA 0 NE
II. Is there evidence of in corre c t land application? Ifyes, check the appropriate box below. 0 Yes ~No DNA D NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Me tals (Cu, Zn. etc.)
D PAN 0 PAN > 10% or 10 lb s . D Total Phosphorus 0 Failure to In corpo rate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drill 0 Application Outside of Ap proved Area
12. Crop Type(s):
13. Soi l Type(s): $olf I &-rc
14. Do th e receiving crops di ffcr from those desit,'llated in th eCA W MP?
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 th e Certificate of Coverage & Permit readily available?
20. Does the facility fail to hav e all components of theCA WMP readily available? If yes. check
the appropriate box.
0WUP 0Chec kli sts 0 Design 0 Maps 0 Lease Agreements
0 Yes ~No DNA ONE
DYes [8No DNA O NE
DYes ~No DNA ONE
DYes ~No DNA ONE
D Yes ~No DNA ONE
DYes 1:8J.No DNA ONE
DYes L'8J. No DNA ONE
Dother:
21. Does record keeping need improvement? If yes, check the approp riate box below. D NA 0 NE DYes 0No
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stoc kin g D Crop Yield 0 120 Minute In spections 0 Monthl y and I" Rainfall Inspections 0 Sludge Survey
22. D id the facility fa il to in s tall and maintain a rain ga uge?
23. If se lected, did th e facility fail to in sta ll an d maintain rainbreakcrs on irri g at ion equipment?
Page 2 of3
DYes ~No D NA ONE
DYes ~o DNA ONE
21412011 Continued
I Facility Number: IDate of Inspection: JE!t; -/;)-I .
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes (g No DNA D NE
D Yes ~No DNA D NE
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 offrrst survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus Joss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Application Field D Lagoon/Storage Pond 0 Other:
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes jgNo DNA ONE
DYes ~No D NA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representati ve ?
34. Does the facility require a follow-up visit by the same agency?
DYes !liNo
DYes ~No
DYes ~No
D N A ONE
DNA ONE
DNA ONE
Comments (refer to question #): Explain any YES ann.·ers and/or any additional recommendations or any other comments.
Use drawings offacility to better explain situations (use additional pages as necessary).,
Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature: Date: --------------------
Page 3 of3 21412011
for Visit:
Date of Visit: 1/VH/ I Arrival Time:l /Oi12o I
Farm Name: tJid11. ril'm1 .#/ tr ~ ~
Departure Timed //·'ro f County;::-~ Region: f=7E;V
Owner Email:
Phone:
Mailing Address:
Physical Address: --------------------------------------------------------------------------------------
Facility Contact: ~ .. ..-~
Onsite Representative: .. 7"4-1<.-
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Di scharges and Stream Impacts
I . I s any di scharge observed from any part of the operation?
Di sch arge origina ted at: D Struc ture 0 Application Field
a . Was the conveyance man-made?
D Other:
b. Did the discharge reac h waters of the State? (I f yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: ~f'
Certification Number:
Certification Number:
Longitude:
DYes ua No
D Yes 0No
D Yes 0 No
d . Docs the di scharge bypass the waste manageme nt system? (If yes. notify DWQ) 0 Yes D No
2. I s there evidence of a past discharge from any part of the operation?
3. Were there any observab le adverse impacts or potenti a l adverse impacts to th e waters
ofthe State ot her than from a di scharge?
Page 1 of3
Q Yes ~No
DYes 6a. No
DNA ONE
DNA ONE
D NA O NE
DNA ONE
DNA ONE
DNA ONE
11412011 Co ntinued
...
!Facility Number: ~ I nate of Inspection: 7/P---2~ /(
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: wrr lowe-,c--
Spillway?:
Designed Freeboard (in): l~ /t
Observed Freeboard (in): ,5._ I 02 .. 2
5. Arc there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes 18-No
0 Yes 0 No
DNA ONE
DNA ONE
StructureS Structure6
DYes ~No QNA ONE
0 Yes U(!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. Docs 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 0 NE
0 Yes ~ No 0 NA 0 NE
I&;J Yes 0 No 0 NA D NE
0 Yes !8 No 0 NA D NE
II. Is there evidence of incorrect land application? lfyes, check the appropriate box below. 0 Yes .18[ No 0 NA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Typc(s): ''kmuda-(bt/r'Yk-r'd I c~,. ~
13. Soil Type(s): $v{2/(;;TC
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. Docs 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. Docs the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
0WUP 0Checklists D Design D Maps 0 Lease Agreements
21. Docs record keeping need improvement? If yes, check the appropriate box below.
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes r2fNo DNA ONE
DYes ~No DNA ONE
DYes rgj No DNA ONE
DYes I3No DNA ONE
Oother:
DYes .t8J No DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections D Monthly and I" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? D Yes g) No 0 NA D NE
23. If selected, did the facility fail to install and maintain rainbrcakers on irrigation equipment?
Page2of3
DYes ~No DNA ONE
2/4/2011 Continued
·•
!Facility Number: ?;: -~3e? I I Date of Inspection: A2 -?7i?f)JA
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes U({No 0 NA 0 NE
~Yes_. DNA ONE
0 Failure to complete annual sludge survey
~Non-compliant sludge levels in any lagoon
D Failure to develop a POA for sludge levels
List structure(s) and date of frrst survey indicating non-compliance: 1~-,;J.-JJ
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
lfyes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field D Lagoon/Storage Pond D Other:
DYes ~No
0 Yes [81 No
DNA ONE
DNA ONE
0 Yes g) No 0 NA 0 NE
DYes [&No 0 NA 0 NE
DYes ~No DNA ONE
DYes jg.No DNA 0 NE
------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP ?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
D Yes KJ No 0 NA D NE
0 Yes ba No 0 NA 0 NE
DYes JiaNo DNA ONE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings offacility to better explain situations (use additional pages as necessary).
~ ci~-.J. pi f';::: b.-/.; ~) fh, '<A,)e 7 ,;-~" j T A OY j,,.,..-1. J,, ok"" ...._ <!J FFJ-
-d-e Gt~ fEfPt't ~ w,5-fr tVtrj 5f;t/-: dr~~ ~.s "<? r r-~y.._ fJF'·
5 .,-Pf' t.t!!-:J; rra?tf.i.,..._ Fr~J?--r;F~ d-~~~~K.IAr ,
@ cL----5/d,r rr,..__ L-;,o"-0
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3of3
Phone: ~Z-.3.?DD
Date: fr;;;:?;j77;2a/ /
21412011
\ .
Type of Visit ~mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: l;l:Jl)-101 ArrivaiTime:l J ~3"0 I Depa rture Time: II 0 :3Q I County: s~~ ·v---' Region:
Farm Name: knt:L Fa.-.rwr~ I t: ? Owner Email: --------------
Owner Name: fiad 0lknas. '&itf3l.k1c(bi 57fic...k\.-J Phone:
.Mailing Address:
Phy sical Address:-----------------------------------------
Facility Contact: Dan&L 61f;c1,}J Title:-----------PhoneNo: ________ _
Onsite Representative: Gl'rce @oocc:.. Integrator: tnu9 f
Certified Operator: ([)~ 577' ~c.-b./~ Operator Certification Numbe r : -------
Back-up Operator: --------------------Back-up Certification N umber:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Strea m Impacts
I. Is any di scharge observed from an y part o f th e operation? D Yes ~No
Di scharge o riginated at: D S tru cture 0 Appli cation Field 0 Other
a . Was the conveyance man-m ade? D Yes 0 No
b. Did the d ischarge reach waters of the State? (If yes, notifY DWQ) D Yes 0 No
c. What is th e estimated vo lum e that reached waters of the State (gall ons)'!
d. Does di scharge bypass the waste management system? (If yes, notifY DWQ) DYes 0 No
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any adverse impacts or potential adverse impacts to the Wa ters of the State
oth e r th a n fro m a discharge?
D Yes ~No
DYes i(J No
11!18104
DNA ONE
DNA O NE
DNA O NE
DNA ONE
DNA ONE
DNA ONE
Continued
.·~
jFacility Number: Y,:Z.-{,Jol Date of Inspection Ill-3D-t<:j
Waste Collection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the struc tural fre eboard?
Structure I
Identifier: lJ.Ifc'
Spillway?:
Structure 2
LJ>.(A,, .... r
Structure 3 Structure 4
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Designed Freeboard (in ): ___ /._9L._ ____ _.1'--<t..._ ________ ------------------
Obs erved Freeboard (in): _ __.3""-...:..1 ___ --·~2-~7~---------------------------
5. Are there any immedi ate threats to the integrity of any of the s tructures observed? DYes
(ie/ large trees, severe e ro s ion, seepage, etc.)
[3No DNA ONE
6 . Are there structures on-site which are not properly addressed and/or managed DYes ~·No DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any ofthe structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or we t stacks)
9. Does any pan of the waste management syste m other than the waste struc tures require
maintenance or improvement?
Waste Application
I 0 . Are there any requ ired buffe rs, setbacks, or co mpliance alternati ves that need
maintenance/improvement?
DYes ltJNo DNA ONE
DYes QZI No DNA 0 NE
fglYes 0No DNA ONE
DYes f8No DNA ONE
11 . Is there e v idence of in correct application? If yes , check the appro pri ate box below. D Yes 29 No 0 NA 0 NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metal s (C u, Zn, etc.)
0 PAN 0 PAN > I 0% or I 0 lbs 0 Tota l Phosphoru s 0 Fai lure to Incorporate Manure/Sl udge into Bare Soi l
0 Outs ide of Acceptable Crop Window 0 Evid ence of Wind Drift 0 Applicati o n Outside of Area
12. Crop typc(s) 'JSrrn,y),_ /ov.,_-c 5cJ fu'P"' ..---
13 . Soi l t ypc(s) D 0 :!_3 J G: rc.
14. Do the receiv ing c rops diffe r from those designated in the CA WMP? DYes ~N o DNA
I 5. Does the recei vi ng crop and/or land app li cati o n site need improvement? 18_ Yes []No DNA
ONE
ONE
16. Did the faci li ty fail to sec ure and/or operate per the irrigation design or wettable ac re determinati on ? DYes 13 No 0 NA 0 NE
17. Does the facility la c k adequate acreage for land application? D Yes fiaNo DNA O NE
18. Is there a lack of properl y operati ng waste appli cation equipment? D Yes [}J.No DNA O NE
Comments (refer to question#): Explain any YES answers and/or any recommendations or any oth~r comments •.
Use drawings of facility to b etter explain situations. (use additional pages as necessary):
9. r) ~ L~a.k ~~ L..vu..;r:-Y t-rpn.-J-;/. 'C.-z.. ?;·rr-(!e;n;,'r'*c---
... -
;s. p,'e'lJ.s j.:;;Vo c~-J~ 11-vJ-h.z:v.-y--!:> N~c J TD /o~ r-c~tP"~J/7") 15~r~-
t'.~ No-t-6 vFFic..~ TO ~k~ u...p -,-/ r N .
rJ~~~ ?ott-F§)f"" J.,..~'D "'-'6t.~J11c... h CA.,!, /;.,,...'L :;-e-./-70 r<.dr-,;1_ f.-.....
Reviewer/Inspector Name I 5~~ G-~~ J Phone: /L.e.-Jt I.r )~o c
Re,'iewer/1 nspector Signature: ~~~ Date: 1/-JO-Lfi;/o
12128/04 Contmue d
I Facility Number: g;;L-b3ol Date of Inspection I /1-Yv -1~
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 0 Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes ~o DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
D Waste Application 0 Weekly Freeboard . 0 Waste Analysis 0 Soil Analysis D Waste Transfers D Annual Certification
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections D Monthly and 1" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes 18lNo DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes lif.No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes R.No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes 18l.No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes 29--No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes fltNo 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 ~0 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: ... -
f-....
Page 3 of 3 12128104
ompliance Inspection 0 Operation Review
Reason for Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Arrival Time: l.:::z! S"o b"'=\ I Departure Time: 13 :~S~-.1 County: ~ ~r:,w Region:~
r s
I
Farm Name: ::f"c:t.No_ .f'a-v!A-1S If 2_ Owner Email:----------------------------
Owner Name: J:xv..,A..: S-fr,'<.k.lcuvc£ -----------Phone:
Mailing Address:
Phys ical Address : ---------------------------------------------------------------------
Facility Contact : PhooeNo: _________ _
On site Representative : G r~v Mo-pr<.. < Integrator: _..:....,4A_-_B~rrv___::.....;..;/l/;..._ ______ _
Certified Operator: t> 9e;oe:::::: sR-.au;:;ct Ri/71 Carl II-· Operator Certification Number: J}{'f3/
Back-up Operator: -----------------------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude :
Discharges & Stream Impacts
I . Is an y di scharge observe d from an y p art of the operation ? DYes r:rN'o 0 NA 0 NE
Discharge ori g inated a t: 0 Stru cture 0 Ap pli cation Field 0 Other
a . Was the conveyance man -made?
b. D id th e disc harge reac h wate rs of th e State ? (If yes , noti fy DWQ)
c. Wh at is th e estima ted volume that reac hed wa ters of th e State (gall o ns )?
d . Does di sc harge bypass th e was te manage me nt system? (If yes, notify DW Q)
2. Is th ere evide nce of a past di s charge fr om any part of th e operation?
3. Were th e re any adve rse impac ts o r potentia l adve rs e imp ac ts to th e Waters of the State
oth er than from a d isc harge?
DYes 0No l:3"ffA ONE
DYes DNo 12J'NA ONE
I
D Yes 0No ffNA ONE
DYes ~. D N A ONE
DY es ra-N'o DNA ONE
12128/04 Continue d
I F~cility Number: 82-~ Date of Inspection liZ -/i'-d CJ I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes. is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: .L4j I ~ 2-
Spillway?:
Designed Freeboard (in): ICf i<j
Observed Freeboard (in): 37 22
5. Are there any immediate threats to the integrity of any ofthe 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
Structure 5
DYes
DYes
DNA ONE
DNA ONE
Structure 6
DNA ONE
DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8 . Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits. dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers. setbacks, or compliance alternatives that need
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes DNA ONE
D Yes ~o DNA ONE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu , Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs 0 Total Phosphoru s D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12 . Crop type( s) B<.k-. ~""-( fk.; ) ) 5 ~ tl (; I'Q i/\J ('o . 5, .)
13. Soil type(s) E/q,JYnAJ j Gv--;+t..J'0
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
DYes
DYes
16. Did the facility fa il to secure and/or operate per the irrigation design or wenable acre determination! 0 Yes
17 . Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
DYes
DYes
~0
No
~0
~ No
. . . , .. . •o .. ... . . i,' .• :--~ . ·. . ~ -~-. ,__ <P ~ • . -· .. ~ .• :;·.. . ~
Coinments (refer to questio~ f#): Explain any YES answer-S and/or !Jiy r~om.inenda:tions or aoy other comments.
Use drawings offacility.to better explain situationS.:(use additional pages as 'oeeeS5ary):' .. ·. · • · • :
,-:, •·. .-. . ~
DNA
DNA
DNA
DNA
DNA
ONE
ONE
ONE
ONE
ONE
·, .. ·,_:
••• •• Qo
·. -.: ...
Reviewer/Inspector Name r {!?};;~ .f2ey e.J..S ·· ··
Reviewer/Inspector Signature: A:lJ:, R ~
.. ~. · j Phone: qJo,'/-33. '3300
Date: 12-//f-200 9
12128104 Continued
..
I Facility Number: 8 2. -~I
l{t'guirf'd Records & Documents
Date of Inspection !1 z -lc,t ~ 91
19. Did the facility fail to have Certificate of Coverage & Permit readily available? DYes
DYes
DNA ONE
DNA ONE 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps D Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~ 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil AnaJysis 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the 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 CAW.MP?
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
GeneraJ Pennit? (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?
Additional Comments and/or Drawings:
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
0N'o DNA-ONE
~DNA ONE o/o DNA ONE
n~ DNA oNE
lli~DNA ONE
~No DNA ONE
DNA ONE
DNA
~ 0NA
ONE
ONE
~DNA ONE
~DNA ONE
DYes ~DNA ONE
I
• -
-....
12128104
/. ( 1-08-0 7
I Facility Number I II
01)'ivision of Water Quality
~z Hfd3o 0 Division of Soil and Water Conservation
0 Other Agency
Type o~.Visit ~mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~e 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access --
DateofVisit: !IZ-10-t~SI Arriva1Time:l2;)1pp-1 DepartureTime: l3:ooe~ I County: Sd"7?Sor/ Region: ~
FarmName: -:::r-~...sw FQ.V~S ~:~'f~ ~ 1
OwnerEmail: _____________ _
Owner Name: l)q N g._.: S"fn ~k~ ~v __ o/ _______ _ Phone:
Mailing Address:
Physical Address:-----------------------------------------
"facility Contact: _..::;G;.__r--_.c,.c...cr __ _,;.Ms.;.__=or<.._.;;___;:=---Title: i ~ . sp~ • Phone No:---------
Onsite Representative: __;;C;;;....-r_u...v ___ M. __ cn:1\'""L.-_--==---------Integrator: _JU__;,iL_vp~S"+-....;:&"--'ro-w........,;;'-N....;;._ ____ _
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
0 Wean to Finish
Iff Wean to Feeder 6900
10 Layer
0 Non-Layer I I 0 Dairy Cow
0 Dairy Calf
0 Feeder to Finish 0 Dairy Heifer
0 Farrow to W can
0 Farrow to Feeder
0 Farrow to Finish
0 Gilts
0 Boars
0 DrvCow
0 Non-Dairy
0 Beef Stocker
0 Beef Feeder
0 Beef Brood Cow
Dry Poultry
0 Lavers
0 Non-Layers
0 Pullets
0 Turkeys
Other D Turkey Poults
D Other Number of Structures: I 2-I IDother
Discharges & Stream Impacts
l. Is any discharge observed from any part of the operation? DYes ~ DNA ONE
Discharge originated at: 0 Structure D Application Field D Other
a. Was the conveyance man-made? DYes 0No ~ ONE
b. Did the discharge reach waters of the State? (If yes , notify DWQ) DYes 0No EtNA ONE
c_ What is the estimated volume that reached waters of the State (gallons)? I
d. Does discharge bypass the waste management system? (If yes, notifY DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
DYes 0No 01fA ONE
DYes w;; DNA ONE
DYes ~DNA ONE
/2128104 Continued
f
!Facility Number: VZ -~3ol Date of Inspection IJz tc -tl' g I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 2 Structure 3 Structure 4
DYes Wo DNA ONE
DYes ~ DNA ONE
Structure 5 Structure 6 Structure 1
:n.-4L/ Identifier: -.::.~o~.,...;;--=-=----~c.... d z.. ------------------------
Spillway?:
Designed Freeboard (in):·--------=.,....---------.,..----------------------------,, /
Observed Freeboard (in): ---=L/~Z.;;...._ _____ .;:;lq~· 3~------------------------------
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 properl y addressed and/or managed
through a waste management or closure plan?
DYes ~ DNA ONE
DYes 8-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? 0 Yes ~· 0 NA D NE
8. Do any of the stuctures lack adequate markers as required by the permit?
(No t applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any pan of the wa ste management system ot her than the waste structures require
ma intenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~ DNA ONE
D Yes ~ DNA ONE
DYes ~DNA ONE
II . Is there evidence of in c orrect application ? If yes, check the appropriate box below. 0 Ye s ~· 0 NA 0 NE
0 E xcessi ve Pondin g 0 Hydraulic Ove rl oad 0 Frozen Ground 0 Hea vy Me ta ls (Cu , Zn, etc .)
0 PAN D PA..I\J > 10% or 10 lbs 0 Total Phosphorus 0 Fa ilure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s) _L:;&n....~1!6...J,Lo......a.d~C!L..---~( ~~-·)~.-1r--='Sj~AA~Al.!..'i.....;a~tz!~'~·A/~~....!:o~.s::....._)::....__ ___________ _
13. Soi l type(s) &15.
1
C.ril:w?+J
14. Do th e recei vi ng cro ps differ from those designated in th eCA WMP?
15. Does the receivin g c rop and/or land application si te need im provement?
D Yes
D Yes
~0NA O NE
~DNA ONE
16 . Did the facility fail to secure and/or operate per the irrigation desi gn or wettable acre determin ation?O Yes ~DNA ONE
17. Does the facility lack adequate ac reage for land app lication?
18. Is the re a lack of properl y operatin g waste applicat ion e quipment ?
DYes
D Ye s
~DNA 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): ..
f-
~ ...
Reviewer/Inspector Name R;~JG.. f?#!.vJ -S Phone: 9JO,fi.J3, "3.330
Reviewer/Inspector Signature: /'SM ~~ Date: Lz-/tJ -2.oofj
11128104 Contmued
'
J Facility Number: sr2 -6521 Date of Inspection l!z~ID-a e 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 , chec k
the appropirate box. D WUP 0 Checklists D Design D Maps D Other
2 I. Does record keeping need improvement? If yes, check the appropriate box bel ow.
DYes ~o D NA ONE
D Yes crNo DNA ONE
DYes l31fo D NA D NE
0 Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Trans fers D Annual Certification
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections D Monthly and 1" Rain In spections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~ D N A ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes r::3'1ro D N A ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit ? D Yes ~ D N A ONE
25. Did the facility fail to conduct a sludge survey as required by the penn it? DYes ~0 D NA ONE
26. Did the facility fail to have an actively certified operator in charge? D Yes 8No D NA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes D"No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CA WMP? DYe s I31'Jo D N A O NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes B1'1 o 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 Gl"N o 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 requi red by DYes 8-N"o DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewerllnspector fail to discuss review/inspection with an on-site representa ti ve? DYes G-No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes C}!q o DNA ONE
' Additional Comments aodlor Drawmgs: ...
1-
-.....
Page3 of 3 1212 8104
Type of Visit <Z><O"mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: ~fi~rrival Time: !1 /I'Vt> I Departure Time: V; 00
FarmName:-ze,...,'o/"' ~/y)rz_ tf?rm L !county:~ Region :;flO
Owner Email:--------------
Owner Name: h2ntryz ltfe /v/ rt--Phone:
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: 7ifzny Jtk/J// ""--Title: -----------Phone No:----------
Onsite Representativ., ~ ~ <....---Integ.ato" 11'-~
Certified Operator: ~7 Ao:.::!%~~-.;;;,tt"'~-'-/_1'\....--..=.______ Operator Certification Number: lb'"?;lb
Back·up Operator: --------------------Back·up Certification Number:
Location of Farm: ..---,oD. D " Latitude: L....J Longitude:
Discharges & Stream Impacts
L Is any disc ha rge observed from any part of the operation? 0 Ye s .ElNo DNA ONE
Discharge originated at: 0 Structure 0 Application Field D Oth er
a. Was the conveyance man-made?
b. Did the di scharge rea ch waters of th e State? (l fyes, notify DWQ)
c . What is the estimated volume that reached wate rs of the State (gallons)?
d. Does discharge bypass th e waste ma nagement system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impa cts or potenti a l adverse impacts to the Waters of th e State
other than from a disc harge?
Page 1 of 3
DYes 0 No DNA O NE
DYes 0No DNA O NE
D Yes 0No DNA O NE
DYes R]No DNA ONE
D Yes fZJ-No DNA ONE
12128104 Continued
Identifier:------------------------------------------
Spillway?:
Designed Freeboard (in): __ _._ft......_' ___ -----------------------------------
ObservedFreeboard(in): __ ..::..~....::_s-=::.... ________________________________ _
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes .18.No 0 NA 0 NE
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
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any ofthe structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
t;Z?J-ves D No DNA 0 NE
DYes ~No DNA ONE
DYes 18l.No 0 NA D NE
DYes CS:No DNA ONE
II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes l8J,.No DNA D NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN D PAN> 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Croptype(s) ~/~/p~ h~bz Jt/£/ ;
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? DYes ~No DNA
15. Does the receiving crop and/or land application site need improvement? DYes ~No DNA
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?O Yes ~No DNA
17. Does the facility lack adequate acreage for land application? DYes I8J No DNA
18. Is there a lack of properly operating waste application equipment? DYes [29.-No DNA
ONE
ONE
ONE
ONE
ONE
Page 2 of 3 12118104 Continued
I Facility Number:T;t--1}5;4 Dateoflnspection ~
Required Records & Documents
19. Did the facility fail to have Certificate ofCoverage & Pennit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. D WUP D Checklists D Design 0 Maps D Other
21. Does record keeping need improvement? lfyes, check the appropriate box below.
DYes ~o DNA ONE
DYes ~o DNA ONE
0 Yes 18-No DNA D NE
D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification
D Rainfall D Stocking D Crop Yield 0 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes _plNo DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the pennit? DYes 1$] No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the pennit? DYes jgJ No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes SNo DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the pennit 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 nonnal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes JKlNo 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 !E-No DNA ONE
General Pennit? (ie/ discharge, freeboard problems, over application) \
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? "DYes ~No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE
• '•~ r ~ • ' -• • ~ ' ' ,'" •\' ' • •
Page 3 of 3 12128104
Q1/LlS 1z//9/zae7
® Division of Water Quality
Facility Number 8z (030 O Division of Soil and Water Conservation
O Other Agency ;4
Type of Visit 6 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: /Z -//-O-j Arrival Time: /2: 53- Departure Time: O/; 3S County: S L -4x n
Farm Name: 1-0_rw c / 4 2- Owner Email:
Owner Name: Sl-vi-Lkl, cl Phone:
Mailing Address:
Physical Address:
Facility Contact: GrL(_t- Itioor< Title: t-�' • S
Onsite Representative: (9t�or Mo�srt
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean t
Wean t
Feeder
Farrow
Farrow
Farrow
Gilts
Other
❑ Other
Latitude:
Region: / i"
oec. Phone No:
Integrator: &AI -24 JFAUW/l
Operator Certification Number:
Back-up Certification Number:
o [--] I E] Longitude: [� O [� , [ a
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑
Layer
40 0001 1LJ Non -Laver
Dry Poultry
Discharges & 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?
Design Current
Cattle Capacity Population
❑ Dai Cow I_
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: FK1''
b. Did the discharge reach waters of the State'? (If ves, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any pan of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [11 No ❑ NA ❑ NE
❑ Yes
[XNo
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[f No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
/2/28/04 Continued
Date of Inspection IIZ·I/-tJ 71
~Collection & Treatment
4. Is s torage capacity (structural plus storm s torage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard ?
Structure 1 Structure2 Structure 3 Structure 4
DYes 11JNo DNA ONE
DYes ~No DNA ONE
Structure 5 Structure 6
Identifier: ______ ---------------------------------
Spillway?:
Desi!:,rned Freeboard (in): -~l...~.'l~,t....5£. _____ .;_I...!,&J_ • ...:;.>_-~-------------------------
~I ,, _, 0' "
Observed Freeboard (in): ___ .L"'--l-------""--()-----------------------------
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 t here structures on-site which arc not properly addressed and/or managed DYes t1J No DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? 0 Yes Q! No 0 NA 0 NE
8. Do any of the stuctures lack adequate markers as required by the permit'!
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9 . Does any part of the waste management syste m other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers , setbacks, or compliance alternati ves that need
maintenance/improveme nt '!
0 Yes ~No 0 NA 0 NE
DYes '7iNo DNA ONE
DYes ~No DNA ONE
II . Is there evidence of in co rr ect application? If yes, check the appropriate box below. 0 Yes {;i No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Me ta ls (Cu, Zn, etc .)
0 PAN 0 PAN > 10% or 10 lbs 0 Total Phosphorus 0 Fa ilure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s) _!:.B~(.o:..~-tw·H~!.ifrJJ.~q.....__u.M:..:!'i:;,;;;tt.......,o,.-_.S'jl!lli!E:::, ~:LJ//t::........l.t:;LL:,.!u'~iV~..J.(,....!~~'~' if5~"-.:~::..:~::::::=....::):..__ ____________ _
13. Soil type(s) B" \3 G ± C..
14 . Do the receiving crops difTcr from those des ig nated in the CAWMP?
15 . Does the recei ving crop a nd/or land application site need impro vemen t?
DYes
DYes
~No DNA ONE
!A No DNA ONE
16. Did the facility fail to se cure and/or operate p e r the irrigation des ign or wettable acre determination?O Yes ~N o DNA ONE
17 . Docs the facility lack adequate acreage for land application?
I R. Is there a lack of properly operating waste application equipment?
DYes
DYes
I;E No DNA ONE
~No DNA ONE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
... ,___
1-...
Reviewer/Inspector Namt> Rt<.lc., R.~Js Phone: 110 . 'I.J'.!, 3 :J" 0
Reviewer II nspector Signature: I<Ml /2,~ Date: /Z -;;-zoo Z
11/28104 Co ntmued
I Facility Number: Yz -/,30 I Date of Inspection l1:z. -ji-o7l
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. D WUP 0 Checklists 0 Design 0 Maps D Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes IYJNo DNA ONE
DYes rnNo DNA ONE
DYes []No DNA ONE
0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis D Waste Transfers 0 Annual Certification
0 Rainfall D Stocking D Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes lt]No DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes Ill No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes I¥JNo 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 cyJ No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes f¥1 No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes []"No DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes []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 b y DYes llJ 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 00No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes [i!1 No DNA ONE
Additional Comments and/or Drawings:
....
f-
1--....
12128104
\
Type of Visit • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 8 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Vi sit : IJI-!il-0~ I Arrival Time : l2 ; J.{) ~ w I Departure Tim e: 13; flO llLu I County: Region: r-;e.o
~;r j
Farm Name: ~ G...N ~ "Fq_.lf-""'-S { ~ 2.. Owner Em a il : -------------1
Owner Name:------------------------Phone:
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Fa cility Contact: G r-~ r Kioo 1.--:L-Title: I'U.J. ¥ fC . Phone No: _________ _
Onsitc Representative: Gre<Z..r Moo ..-<: Integrator: M !.A"=f> s &-o wtJ
Certified Operator:--------------------Operator Certification Number: ---------
Back-up Operator: --------------------Back-up C e rtification Number:
Location ofFar-m: Latitude: D OD 'D " Longitude: D oo ··o ..
Di scharges & Stream Impa cts
I . is any di sc harge observed from an y part of th e operati on ? D Yes 00 No DNA O NE
Discharge originated at: 0 St ru cture D Appl ica tion Field 0 Oth er
a. Wa s the conveyan ce man -mad e? DYes GJ'N o DNA O NE
b. Did the disc harge reach waters of the S ta te? (If yes, notify DWQ ) D Yes ~No DNA ONE
c . Wh at is the estim ated vo lum e that re ached wate rs of the Sta te (ga ll ons)?
d. Does d isc harg e bypass the waste manage me nt system? (If yes, noti fy D WQ) D Yes ~No D N A O NE
2. Is th ere eviden ce o f a p as t di scharge from a ny part of the o peration ?
3. We re there any adve rse impacts or potentia l adve rse impacts to the Waters of the State
othe r than from a di sc harg e?
Page 1 of3
D Yes (2g No
D Ye s ~No
12/28/04
D NA O NE
D NA O NE
Continued
,; J Facility Number: ~Z-~30 J Date oflnspection 111-11-o<;;l
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: L_fl:L ~2 Spillway?: 0
Designed Freeboard (in): LCf.~ l2r 5"
Observed Freeboard (in): 3o Z$
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 cgNo DNA ONE
DYes l29No DNA ONE
Structure 5 Structure 6
DYes ~No DNA ONE
DYes ~No 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 stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~o DNA ONE
DYes [BNo DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
ll. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes !)a No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 1bs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12. Crop type(s) B~-VI+l'1 k...ll;y 5~51/ ~ralN' {D. St)
)
13. Soil type(s) BoB G=TC....
/
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 ~No DNA
DYes ~No DNA
ONE
ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? DYes [A1 No 0 NA D NE
17. Does the facility lack adequate acreage for land application? DYes ~No DNA ONE
18. Is there a lack of properly operating waste application equipment? DYes ~No DNA ONE
Comments (refer to question#): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
... r-
r-.....
"'f<~c-_~ l<e_ ;;;IS:"" . ----. . ~ .. ~-·-· . l Phone: (Of/D) '-133-335f) Reviewer/Inspector Name
Reviewer/Inspector Signature: R.. :J! /<..a. ~~-Date: II-/~ -zoo tP
Page2of3 12128104 Contmued
I Facility Number: $z_ -~301 Date of Inspection 1/l-!f'-Okl
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Penn it readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. 0 WUP 0 C hecklists 0 Design D Maps 0 Othe r
DYes rXNo DNA O NE
DYes IXf No 0 NA 0 NE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes I)J1No 0 NA D NE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers D Annual Certification
D Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspecti ons D Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE
23 . If selected, did the facility fail to install and maintain rain breakers on irrigation eq uipme nt? DYes J;iPNo DNA ONE
24. Did the fac ility 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 ~0 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 sec ure a phosphorus loss assessment (PLAT) certification ? DYes J&1" No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-complian ce of the perm it orCA WMP? DYes ~No DNA O NE
29 . Did the facility fail to properly dispose of dead animals with in 24 hours and/or document DYes ~No DNA ONE
and report the mortality rates that were higher than nonnal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~0 DNA ONE
If yes , contact a regional Air Quality representative immediately
31 . Did the facili ty fail to notify the regional office of emergenc y si tuations as required by DYes ,D'!No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/In s pector 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: ..
• -
-.....
Page3 of3 12/28/04
\
Type of Visit e Compliance lnspedion 0 Operation Review 0 Lagoon Evaluation
Reason for Visit e Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access
II 16-. HL__j I Date of\'isit: IIO·tJ .Oif I Time: Ia; If 0 Facili~· :"umber 1 p,r< r--1 fi!O ! · -· ·-
L __ :_::::~~=:.......:::::;::=::::_~~~~~:._--j! IO 1\"ot Operational 0 Below ThTeshold
ltl-Pe'Tmitted ~rtified []Conditionally Certified Date Last Operated or Abon Threshold:
Farm ~arne: Coun~·: Sa¥s on &o ·
Owner :\"a me: _--=:E..!:::!ev:!....L./__.!M!=:u.lt.~.:.s __ ------------PboneNo: Cf!o S"'.,~-3GI'f
Mailing Add rcss: ._f:...o. {)'-'';........:o4""'D""x'-----'g,:;...;:~:;..,;J::;;.... _ ___..(..,"'-'/,-"':,.._f,.:;<,.'"'-?-"'"""""f,I;;.._;C. __ .. .2,._8 J .:2 Cf
Facility Contact: __,0...,B:u:-...,.~,__---'$"'"'f'-r'""'''"".''""k.:..:l..-.•..,. .. ,.(~---Title: ----------Phone !\o: 9/o-
On site Representative: __.()"""o"""""'tJ--~.S ... -I.~,.. ....... : ... e~h .... l. ... q .... ,..._.,./...._ ______ _ lntegrator: -.:./"T....!..!v::.J,-,~)Il=~'.J'Y~·~I'i~~~Dr,!.t,.,..,fti!!!!IL.-------
Cenified Operator: __ ...liiJ~c;.aG-'""'------..i~.Su:f....:,.;..J•..&.'r;!;k:.!.l.ae~.,u,.{ll{,..... ___ _ Operator Ct>rtification !\umber:
Location of farm:
I:E"Swine 0 Poultry 0 Cattle D Horse Latitude L---...JJ•I ._ _ _.I' '-1 __ ...JI"' Longitude .______.I• ._I _ _.1·1 .__ _ _,J ..
Design Current Design Current Design Current
Swine Capacitv Population Poultry Capacin· Population Cattle Cal!acin· Pol!ulation
~ean to Feeder {,'-foo (, ~CJO []Laver I I I 10 Dairv I I I ] Feeder to Finish IONon-Laver l I I :o Non-Dairv :
0 Farrow to Wean
IDOther 0 Farrow to Feeder I I I
0 Farrow to Finish Total Design Capacity I I
0Gilts I I 0 Boars Total SSLW
Number ofugoons I .2 I ID Subsurface Drains Present liD Lagoon Area ID Sl!rn Field Area I
Holding Ponds I Solid Traps I I ID l'o Liguid Waste Management Svstem l: .;.· ·.:.. . .
Discharges & Stream Jmpacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 La2oon 0 Spray Field 0 Other
a. If dis::harge is observed, was the conveyance mar.-made?
b. lf discharge is observed. did it reach Water of the State? (lf 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 If Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? 0 Spillway
Identifier:
Freeboard (inches):
05/03101
Structure I
r3 ',,
Structure 2 Structure 3 Strucrure 4
-<
StructureS
DYes ~
DYes G:t1fo
DYes ~0 -D Yes GJ.Ko
DYes GJ-No
DYes G}No
D Yes [31<o
Structure 6
Continued
!Facility Number: 1 ;J. -(, J () j Date of Inspection II o-13 ·or I
5. Are there any immediate threats to the integrity of any of the structures observed? (ie! trees, severe erosion,
seepage, etc.)
6. ~ there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4.fi was answered yes, aud the situation poses an
immediate public health or environmental threat. notify DWQ)
7. Do any of the stJUctures need maintenancefunprovement?
8. Does any part of the waste management system other than waste structures require maintenancei"LIDprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10 . Ate there any buffers that need maintenanceflmprovement?
11 . Is there evidence of over application? If yes, check the appropriate box below.
D Excessive Ponding D PAN D Hydr.wlic Overload 0 Frozen Ground D Copper and/or Zinc
.:l-.3 ~ F J -> .z .,.,.-~ b ·~ "1. r
12. Crop type /ic,..mw ,/A . .S,a II ~~ •. ·., L. tun
. ' 13 . Do the receiving crops differ with those 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 at/or below
liquid level of lagoon or storage pond with no agitation?
18 . Are there any dead animals not disposed of properly within 24 hours?
19. Is there II:DY evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building sttucture. 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 represenwive immediately.
•S
ReviewerJIDSpector Name
Date:
12112103
DYes [311fo
DYes I3'No
DYes ~
DYes ~0
DYes ~
DYes B'l'fo
DYes G}No
DYes ~
DYes ONo
DYes 0No
DYes ONo
DYes 0No
DYes 8-NO
DYes DNo
DYes ~
DYes [3-No
DYes GJ.Ho-
• ·j Facility Number: 9;2 -t,jo j Date of IDspec:tion I I 04 .-o Y I
Required Records & Documents
21 . F~ 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?
(ieJ ~~ts, ~ • ..tHJ55, ett:.)
23 . Does record keeping need improvement? If yes, check the appropriate box below.
0 Waste Applicatiorf 0 I'Ha8e81'8 0 Waste Analy sis' 0 Soil Sampling_..
24. Is facility not in compliance with any applicable setback criteria in e ffect 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 Pennit?
(ieJ discharge, :freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss reviewfmspection with on-site representative?
28. Does facility require a follow-up visit by same agency?
29 . Were any additional problems noted which cause noncompliance o f 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.
0 Stocking Form 0 Crop Yield Form 0 Rainfall 0 Inspection After 1" Rain
D 120 Minute Inspections 0 Annual Certification Form
12112103
!\/~"" IRII -f
Ne~~V I~R-:2
"If
DYes 8-No
DYes ~
DYes DNo
DYes [31<o"
DYes @NO
DYes [3-NO
DYes [3-No
DYes [3-No
DYes [3-No
DYes 13-No
DYes 0No
DYes 0No
DYes 0No
DYes ONo
DYes ON<?
--·-------. .
Division of Environmental Management
Animal FeedJot Operations Site Visitation Record
. . ~:.3o~\·~~. ..
TUDe: \~00 . ,
. . . ~
GenerallnfonnatJop: .
. FannName: -~N; £~'\~~ ·. CoUnty: .. s.\~~'Dtv
. OwnerN~ . ~ ~(Lh.> \J.)CU,..l;~ . Phone No· -~~2.-l~\ 1
on· site Representative: ~E;'c:.~~ -1)~. ~-' Integrator: =t~u)_).)-:-.5_. -----
MailingAddn:ss: Z52..~ £.J.t.\"~ W\~\';) ~~ . .
tAlill't'otV, ~-C.,. ~~il
Phyg~Ad~~------------------------------------------------------
I Latitude: I I Longitude: I I
Operation Description; ~d ou desfp charaderfsdcs)
Type of Poultry No. of A1UmtJJ.s
Ol..a)w
7)pe of Ctmle No. of AnitMb
ODaizy
a NOJ!.t.a,er OBccf
N~r of AliimaLr:
Nllmber of Lagoons : Z (iDclodc iD 1hc Drawings ud Observations the freeboard of each Ja&ocm) ·.
facnity Inspection;
Lagoon • .
IS lagoon(s) f=boanlless thml ·~ + 2S year 24 ~our stonn storage?: ~ ~ ~ i" · Y~ No 0
. Is seep.age observed from the.Jagoon?: . . . . . . ~ ~~ . Y~ Q No'Rf
Is eroSion observed?: -· · Y~ Q ·No lit
I
Is any discharge .obServed? Y~ Q No~
0 Mllll..,.U · 0 Not M~
Cover Crop U AY ( C..O~~AL}
Does the facility need more aaeagc for sprayiug?:
Docs the cover ~rop need impmveme:Dt'l:
(list '1M crops "'(IUcA rr.te4 imprt1VDBIIIII)
~type: .UA~~5~J>~s\~
YesO Nofll ·
Yes~ Notl ·.
.. :-:. ~
· .... ···sethaclc ~ . ·.· .. ~ : .... :·· · · · · · • . . . .... _ -.. ·. .-. ''!' • • -· . . ..
: Is a dwe~g lo~ted withiri. 200 f~ ~i ~aste· applic&tion? ~ ·• · . · .. ·· .. ·~~:() .. ··.No~ .· :~.:
: . ·: ~-YesO ·.-No~·_:.._~· -. · : . Is a wen located Within I 00 feet of waste· &~)plication? :: -~ · ~ : . . . -.. . . ·-
Is an~ w~te. st~kpil~d widun 100 feet of USGS Bl~e Line Stream? .
Is animal waste land applied or spray irrigated within 2S feet o~Blue Line Stream?
A.OI-JUllW)' 17.1'H
.. y~Q Nol)
y~[J No,:, · ···
----------------
-::.·. ~-·. • -. ·. Main.UIIIIIU¥ . . . ~ ---..:.-..noes· the facility maintenance need improvemem? YesO Noi(
YesO Noll
YesO No~
.Yesp: NoC
Is there evidence of past discharge from any part of the operation?
Does record keeping need improvemc:Dt? ·. ·
Did the facility fail to have a copy of the Animal Waste Management Plan on site?
:'::~~
Drawinp or Observations:
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Date: 3o Juty '1V,
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