820644_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quality
Date of Visit: [J 1 "d' .;'4 1•/ ~rrival Time:~
Farm Name: f? dJt!cX-e;'fue_ ;f~~--
Departure Time: I B'w,J (county: sdtJr
Owner Email:
Region: p=f20
Owner Name: {3 M?.c 6~"' Phone:
Mailing Address:
Physical Address:
Facility Contact: -~6':~.-.-tu:....:~~==~;......:.;.<....!.{S....;..· -~--L..:..~...:;;_y-~---Title: Phone:
Onsite Representative: ({ Integrator: 1 M g -S
Certified Operator: It Certification Number: 78"-7 3 o0
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation? DYes []}Nt:rO NA 0 NE
Discharge originated at: D Structure D Application Field 0 Other:
a. Was the conveyance man-made? DYes 0No £:a..NK D NE
b. Did the di scharge reach waters ofthe State? (If yes, notify DWR) DYes 0No [JN:t\0 NE
c . What is the estimated volume that reached waters of the State (gallons)?
d . Does the discharge bypass the waste management system? (lfyes, notify DWR) 0 Yes 0No CJ"t'A 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 di sch arge?
f-lof3
0 Yes gt DYes No
DNA ONE
DNA ONE
11412015 Continued
IFacilitt Number: I Date oflnspection: fll !fJ7(#I / f
Waste Collection & Treatment
4. ~ 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 Structure3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~NA ONE
DYes 0No ~ ONE
Structure 5 Structure 6
0 Yes ffNo DNA 0 NE
DYes~ DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
@o any of the structures need maintenance or improvement? ~s ~o D NA 0 NE
8. Do any of the structures lack adequate markers as required by the permit? D Yes [J}No D NA 0 NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers , setbacks, or compliance alternatives that need
maintenance or improvement?
DYes~ DNA ONE
DYes DNA ONE
II. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. DYes DNA ONE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu , Zn, etc.)
0 PAN D PAN> 10% or 10 lbs . 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Evidence of Wind Drift 0 Application Outside of Appro ved Area
12. Crop Type(s): sc,-v
13. Soil Type(s):
14. Do the receiving cro ps differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
0 WUP 0Checklists 0 Design 0 Maps D Lease Agreements
DYes ~ DNA ONE
DYes [g--rfo DNA ONE
DYes 01'fo DNA ONE
DYes @1'lo DNA ONE
DYes ~ DNA ONE
DYes ~o DNA ONE
DYes ~o DNA ONE
DOtber: ________ _
2 I . Does record keeping need improvem ent? If yes, check the appropriate box below. 0 Yes f:tNo 0 NA 0 NE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Weather Code
D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections D Monthly and 1" Rainfall Inspec tions 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes EJ'1fo 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation eq uipm ent? 0 Yes ~o 0 NA 0 NE
Pagel of3 11412015 Continued
c 'fl I Facility Number: !Date oflnspection: /.} 1Jc.r..v{~ •
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25.1s the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes [9-"NO D NA 0 NE
DYes ~DNA ONE
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the 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
pennit? (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:
DYes [3-No DNA ONE
DYes ~DNA ONE
DYes [Z]..M) DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes [3fo DNA ONE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes ~ DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
--
o, Sd
~ t-~~b{ t-c -~
Reviewer/Inspector Name :
Reviewer/inspector Si!,'ll ature :
Page 3 of3
DYes c:rNo
DYes uNo
9/ "'b r ~~ r7
a oro
DNA
DNA
~ \)U"[ bo .. /t:c'
ONE
ONE
Ph one: ·'110' 3-33?-f
Date : ~~ ~Uf.J g'
214/1015
'-~ ...... · .... ,:_;,. ... ~ ..... -...-_..,..;,..,..---~ .........
Operation Review Structure Evaluation Technical Assistance
0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 111 s~ H 1
Farm Name: ·B 'II'U.C~
DepartureTime:I/DI,Jo41 County: slj-t11 Regionf:(Z£)
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: I ( Title: --------~-------------------Phone:
Integrator: ~ {j-..f ----------------------------Oosite Representative: I c
Certified Operator: t( Certification Number: f ~ 7-3 0-.$-,
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation? 0 Yes g-6'0NA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other:
a. Was the conveyance man-made? DYes 0No ~-ONE
b. Did the discharge reach waters of the State? (If yes, notifY DWR) 0 Yes 0No q.~ ONE
c . What is the estimated volume that reache d waters of the State (gallons)?
d . Does the discharge bypass the waste management system? (If yes, notifY DWR) DYes 0No cat A ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
0 Yes
0 Yes ~ DNA ONE
DNA ONE
214/1015 Continued
IFacilit)' Number: loate of Inspection: ,,._ 3??f z·a
Waste CoUection & Treatment
4 . is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
· Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ?..l
5. Are there any immediate threats to the integrity of any ofthe structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6 . Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~NA ONE
0Yes ·bNo ~ONE
Structure 5 Structure 6
DYes~ DNA ONE
0 Yes [;}NO 0 NA 0 NE
If any of questions 4-6 were. answered yes, and the situation poses au immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the pennit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9 . Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
0 Yes
DYes
DYes
0 Yes
[3<o DNA ONE
~ DNA ONE
~0 DNA ONE
~0 DNA ONE 10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
II. Is there evidence of incorrect land application? Ifyes, check the a ppropriate box below. 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. 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): i3~~f
13 . Soil Type(s):
14 . Do the receiving crops differ from those des ignated in theCA WMP?
15. Does the receiving crop and/or land application s ite 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 a ppli cation?
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 re adily available? If yes, check
the appropriate box.
OwuP 0 Checklists 0 Design 0 Maps 0 Lease Agreements
2 1. Does record keeping need improvement? If yes, c heck the a ppropriate box below.
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes No D NA ONE
DYes Ei0NA ONE
0 Yes No DNA ONE
O other:
0 Yes ~DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soi l Analysis 0 Waste Trans fers 0 Weather Code
0 Rainfall 0 Stocking 0 C rop 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?
23 . If selected, did the facility fail to in stall and maintain rainbreakers on irri gation equipment?
P11ge 2 of3
0 Yes cif'No 0 NA 0 NE
DYes ~o D NA ONE
214120 I 5 Continued
I Facili~ Number: loate of Inspection: t2. s~ B"'f
24 .. Did the facility fail to calibrate waste application equipment as required by the permit?
• 25. Is the facility out of compliance with pennit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes (31'10 0 NA 0 NE
DYes~ DNA ONE
0 Failure to complete annual s ludge survey 0 Failure to develop a POA for s lud ge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non -compliance:
26. Did the facility fail 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 o r 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., di s charge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field D Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
~Lbr-4-'.a, ../
) {v4-( tu~{ ..
Reviewer/Inspector Name:
Reviewer/Inspector Signature :
Page3of3
?: ,)... t( -I (,..
IlL~(-/b -o .. t(t..( F-3.~
DYes ~DNA ONE
0 Yes [J<o" DNA ONE
0 Yes ~DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
~ 0 Yes 0No DNA ONE
0 Yes ~ DNA ONE
0 Yes EfNo DNA ONE
0 Yes ~ DNA ONE
Phone: l (0-'fJJ 33 S tf
Date: f 2-SV f f"J
214/2015
Operation Review 0 Structure Evaluation
Reason for Visit : 0 FoUow-u 0 Referral 0 Emergency 0 Otber
Date of Visit: · . -c. . Arrival Time: r:t:Ji1f:j3 Departure Time: I rt oil/f I Coun~: S4Jit
· &. ~iS u....f/ ~ Owner Email: Farm Name:
Owner Name: t( Phone:
Mailing Address:
Physical Address:
Facility Contact: ___ .....;.:./~(:....__ _______ Title: Pbooe:
Onsite Representative: t( Integrator:
Certified Operator: Certification Number: 1 ~ 7 3 OS
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation? DYes ~DNA ONE
Discharge originated at: D Structure D Application Field D Other:
a. Wa s th e conveyance man-made? DYes 0No EJ"'NA ONE
b . Did the discharge reach waters ofthe State? (If yes , notify DWR) DYes 0No ~A ONE
c. What is the estimated vol ume that reached waters of the State (gallons)?
d . Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No OZA 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 di sc harge?
Page 1 of3
0 Yes ~ 0 Yes
DNA ONE
DNA ONE
11412015 Continued
I Facilit>=Number:
< 16-6Y2 (Date of Inspection: t6 s$f/4
Wpte Collection & Treatment
4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): t &
5. Are there any immediate threats to the integrity of any ofthe structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes~ DNA ONE
DYes 0No ~ONE
Structure 5 Structure 6
DYes ~ DNA ONE
DYes ~o DNA ONE
If any of questions 4-6 were answered yes, and tbe situation poses an immediate public health or environmental threat, notify DWR
7 . Do any of the structures need maintenance or improvement? ~ -0"No 0 NA 0 NE
'oYes ~o DNA ONE 8. Do any of the structures lack adequate markers as required by the permit? 0 N ,
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~o DNA ONE
/ 0 Yes 0 No D NA 0 NE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~No D NA D NE
0 Excessive Ponding D Hydraulic Overload 0 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 0 Application Outside of Approved Area
12 . CropType(s): ZeY"~ YlJA:( ,5 (9 0
13. Soil Type(s):
14. Do the receiving crops differ from those des ignated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17 . Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
Required Records & Documents
19 . Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
0WUP 0Checklists D Design 0 Maps 0 Lease Agreements
21. Does record keeping need improvement? lfyes, check the appropriate box below.
DYes
DYes
DYes
DYes
DYes
DYes
DYes
00ther:
DYes
tfNo DNA ONE
~0 DNA ONE
~0 DNA ONE
~0 DNA ONE
~0 DNA ONE
jB'No DNA ONE
B1'fo DNA ONE
~0 DNA ONE
0 Waste Application 0 Weekly F reeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rai nfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" R.ainfalllnspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes [2f'"No 0 NA D NE
23. If sele cted, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~No 0 NA 0 NE
Page 1 of3 214/2015 Continued
IFacilit)t Number: IDate oflnspection: /b SrJf/ q
21~ 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 ~o DNA ONE
DYes [lrNo DNA 0 NE
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond D Other:
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 [2fNo
DYes ~o
DYes
DYes
DYes
0 Yes
DYes
DYes
DYes
~0
~0
~
~0
~0
(Z(No
~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
~o~~e,n~_fr.~f~r to;~uestio~)~Y~.~~e~~~r~~S ~riswers a_n_dlor any addl~;~~eodatioos·orany other c~.m~
J]se di,awmgs:o( facility to better.;expl!lllll!!~~atioos (use additional pages .as}oec.ess_llJ~)t:-: ·· · · ·. · i?,!~Jl
aJ~~~--f1 ~
Sl~.eS~v 6 _ C{~t-f'·?~r
l{~%
ffl_ Grvc.. &1/M,;._ -/ve&+4/8hlf<~4 {!)~ covcv-o"'"
L~r~ /t/1~4r~ ·
Reviewer/Inspector Name: '3 l \\ 'Q ~
Reviewer/Inspector Signature: £b,iJ ~
Page3of3
Phone: ~3~t:)
Date: . ~ I
214/2015
Reason for Visit: 9-Routine 0 Complaint OOther
Date of Visit: ~ A~rrival Time: I 7 ~ lf:S~
Farm Name: -()~ ~
----~--------~--~~-------------------
Departure Time: I 7 ~ 1 04 I County: _<_s:'~-­
Owner Email:
Owner Name: 8 ~'l -~Jfev--Phone:
Mailing Address:
Pbysical Address: -------------------------------------------------------------------------------
Facility Contact:
'
-~($:;..:(CL.£;:..:::....:::;...:"'l~\4o.L-:;cdf~~--"' ___ Title: ______ _ Pbone:
Onsite Representative: l ( Integrator: _.Af....!:...-6 ________ _
Certified Operator: d 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? DYes ~DNA ONE
Discharge originated at: 0 Structure D Application Field 0 Other:
b . Did the di scharge reach waters ofthe State? (If yes, notify DWR)
DYes 0No ~ONE
DYes DNo ~ONE a. Was th e conveyance man-made?
c . What is the estimated volume that reached waters of the State (gallons)? /
d . Does the discharge bypass the waste management system? (lfyes, notify DWR) DYes 0No ~A ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Pagel of3
DYes gt DYes No
DNA ONE
DNA ONE
2/4/l014 Continued
I F'acility "'Number: '4{1 !Date oflnspection: /6.l'""u~(3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 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 @-Nt> DNA 0 NE
DYes DNo em 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 of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes
DYes
~DNA ONE
~DNA ONE
D Yes L]1ifu" D NA 0 NE
DYes~ DNA ONE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~ D NA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10 % or 10 lbs. 0 Total Phosphorus 0 Failure to Inc orporate 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): z~~
13. Soil Type(s): w
14 . Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a Jack of properly operating waste application equipment?
Required Records & Documents
I 9. Did the facility fail to have the Certificate of Coverage & Permit read ily avai lable ?
20. Does the facility fail to have all components ofthe CAW MP readily available? If yes, chec k
the appropriate box .
DYes ~ DNA
DYes ~DNA
DYes ~DNA
DYes gf DNA
DYes No DNA
DYes ~ DNA
DYes ~ DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Oother: __ ....,_ _____ _
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~: DNA 0 NE
Dwup 0 C hecklists D Design D Map s D Lease Agreements
0 Waste Application 0 Weekly Freeboard D Waste Anal ys is 0 Soil Analysis D Waste Transfers D Weather Code
0 Rainfall D Stocking D Crop Yield 0 120 Minute Inspections D Monthly and 1" Rainfall Inspections 0 Sludge Survey
. DYes~ DNA ONE
23 . If selected, did the fa cility fail to in sta ll and maintain rainbreakers on irrigation eq ui pment? 0 Yes [2fNo DNA 0 NE
22 . Did the facility fail to install and maintain a rain ga uge?
Page1of3 11411014 Continued
I
IF'acility rqumber: r:Z: -tzqq I IDate of Inspection: /{) ::r-y /r1
24. Did the fac ility fail to calibrate waste application equipment as required by the permit? 0 Yes II].>t6 D NA 0 NE
25. ls the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes ~ D NA 0 NE
the appropriate box(es) below.
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
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)
DYes
0 Yes
DYes
DYes
DYes
DYes
~ DNA ONE
~ DNA ONE
j31=fo DNA ONE
~ DNA ONE
~ DNA ONE
~ DNA ONE 31. Do s ub surface tile drains exist at the facility? Jf yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other:
---------------------------------------------~ 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer!lnspector Name:
Reviewer/Inspector Signature:
Page 3 of3
DYes DNA ONE
DYes ~ DNA ONE
DYes ~0 DNA ONE
P-3. b
Phone:'-} 35-33J~
Date : {t ~~~ S
11411014
ompliance Inspection
~utine 0 Complaint
0 Technical Assistance
0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: . g z§u?ft(l Arrival Time: I (o ~ ~ ''''3 s~ Departure Timed /H ~ I County: . ~
FarmName: e~&-' ~-(
OwnerName-:--~-1?--~~------~---:;{l--~~---------------------
Mailing Address:
Owner Email:
Phone:
Region: 'ftCU
Physical Address: -----------------:I'T"""--------------------------------------------------------------------..Jio(S...L!..ftc..e'<.-=~:.._...;~:.....____:...:...;&:....._V\. ___ Title: ----------Facility Contact:
Onsite Representative: ( (
Certified Operator: {(
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field
a. Was the conveyance man-made?
0 Other:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: __ ...:.yt{ __ i{=----------
Certification Number: l(~73o5
Certification Number:
Longitude:
DYes ~DNA ONE
DYes 0No l&}-NA ONE
DYes 0No ~ ONE
./
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes g: ~ ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes
DYes
DNA ONE 6: DNA ONE
21411011 Continued
• !Facility Number: lnate oflnspection: flot;; ·l/ /f!
•'Waste Collection & Treatment
4. ls storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structUral freeboard?
Structure I Structure 2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~DNA ONE
DYes 0No ~ ONE
Structure 5 Structure 6
~0No DNA ONE
[d"'fes 0 No 0 NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat. notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~ DNA ONE
0 Ye s [3--No 0 NA 0 NE
0 Yes (il}k> DNA 0 NE
0 Yes DNA ONE
ll. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes DNA ONE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure /Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): ~e/"~4 SCo 1)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
Page 2 of3
DYes
DYes
DYes
DYes
DYes
DYes
DYes
00ther:
DYes
IQ-*0 DNA ONE
~ DNA ONE
~ DNA ONE
~ DNA ONE ~ DNA ONE
~ DNA ONE
[A1% DNA ONE
~0
21412011 Continued
.. ~ -~ !nate of lns2ection: ·a;t/lo~ -111 !Facility Number:
,~24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~ DNA ONE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes
the appropriate box(es) below.
g-no DNA ONE
D Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
-If-trr-v(;]
Revi ewe r/Inspector N ame:
Rev iewer/Inspector Signature :
Page3of 3
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~0 DNA ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~0 DNA ONE
DYes [!J'No DNA ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
or
Phon~ /0 -l(!3-3&3 V
Date: !J-7 /jOG / ~
2/4/1014
Denied Access
IJ6l)3 I Arrival Time:I/D\-'If Departure Timed t/!.fV I County~~
Farm Name::....__ _ _.~.....t....:....~-~\J.::::3:.._~---!--.!.-e~ ____ _
Date of Visit: Region: '['tLo
Owner Email:
Owner Name: .rt Phone:
Mailing Address:
Physical Address: ------::------....,..,--+-+---------------------......,~-ll--1-------__.;;.~~.;..,=.,...:,-i3~;>fl....L::......~-~ Title:___ Phone: tf5 f I Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure 0 Application Field
a. Was the conveyance man-made?
0 Other:
b. Did the discharge reach waters ofthe State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Integrator: _..:..fh.....:....::&-.... _________ _
Certification Number:
Certification Number: ,.
Longitude:
DYes ~DNA ONE
DYes 0No ~A ONE
DYes 0No [JJ.Mi\ ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No ~ ONE
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes
D Yes
~ [L)NA ONE
~ DNA ONE
214/2011 Continued
I Facility Number: !Date of Inspection:
Waste CoUection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a . If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/o r managed through a
waste management or closure plan?
DYes ~o
DYes 0No
DNA ONE
DNA ONE
Structure 5 Structure6
DYes ~ DNA ONE
DYes ~o DNA ONE
If any of questions 4-4i were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do an y of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the pennit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9 . Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes
0 Yes
~
~
DNA ONE
DNA ONE
DYes~ DNA ONE
DY es ~ DNA ONE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~o 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 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): t-eG o
13. Soil Type(s):
14 . Do the receiving crops differ from those designated in the CAWMP?
15. Does the re ceiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box.
OwuP 0Checklists 0 Design D Maps 0 Lease Agreements
DYes ~0 DNA
DYes [j?No DNA
DYes (Lt'No DNA
DYes ~0 DNA
DYes 0"No DNA
DYes ~ DNA
DYes ~ DNA
00ther:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~0 DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Inspection s 0 Sludge Survey
22. Did the facility fail to in stall and maintain a rain gauge? 0 Yes ~o 0 NA 0 NE
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes BNo 0 NA 0 NE
Page 2ofJ 214/2011 Continued
!Facility Number: lf' )-. -''I'{ I !Date oflnspection:* b«--,(51
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes ~ 0 NA 0 NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check D Yes ~ 0 NA 0 NE
the appropriate box(es) below.
0 Failure to complete annual sludge survey DFailure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indi cating 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 pr'?perly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal ?
29. At th e time of the inspecti on did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative im mediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
pennit? (i.e., discharge, freeboard problems, over-application)
DYes
DYes
DYes
DYes
DYes
DYes 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field D Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? D Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes
34. Does the facility require a follow-up visit by the same agency? 0 Yes
~ DNA ONE
~ DNA ONE
U)..K<( DNA ONE
~ DNA ONE
~ DNA ONE
[91( DNA ONE
~ DNA ONE
~ DNA ONE
DNA ONE
C!J,rp.meots.(refer to question tf): Explain any YES answers and/or any additional recommen_dations or any other ·comrri'eiltS;~-
tJ~i'drawings offacility to better explain situ~tions (use additional pages as necessary). -· · -~,it_~
1 :>---~ -1 J--0
,~ -
Reviewer/Inspector Name: ~o::;,"-~·,o..~~~-D..:...~.a.lffl~~·..L\~~ri--~--------------------------­
Reviewerllnspector Signature: -~.,.,--.·....,I.,,.Q .... )~_, ....... D"""" ....... ~..:;..;.---'I:._------------------------
Page1of3 J 114/2011
Operation Review 0 Structure Evaluation
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency
Date of Visit: l GIS1s} !'~-I ~rival Thne:l Ill() f:lf"2 .Departure Time: I 'i! 30 J21'\ I County:$ arnJ?SoA
Farm Name: 'Ro }l t.R.1 1!,\.2'\\f.~ Owner Email:
Owner Name: \\ ob~f.' ~QC-e. J)g=\=\£.'l Phone:
Mailing Address:
Physical Address: .
Region: FR.d
--------------------------------------------------------------------------------------
Facility Contact:
Onsite Representative: ~ ~f"\IL
--~-------------------------------------
Certified Operator: \\o'n't~ ~uc~ ~v+\'Lll.
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field D Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volwne that reached waters of the State (gallons)?
Phone:
Integrator: \'1\u P..~~ {) Row'i>
Certification Number: ~ ~"\ ~S --~---------------
Certification Number:
Longitude:
DYes s'No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notifY DWQ) DYes 0No DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes
DYes
@'No DNA ONE
ciNo DNA ONE
214/2011 Continued
I .: .......
1 Facility Number: lnate oflnspection: 00.\a~v~-
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:
Spillway?:
Designed Freeboard (in): lq ---=----
Observed Freeboard (in): 31 ____;::;_ __ _
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 Y~s [S(N~ DNA ONE
0 Yes 0 No 0 NA 0 NE
Structure 5 Structure6
DYes [i}'No 0 NA 0 NE
DYes SNo DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes CJtNo
DYes gNo
DYes ~No
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
11. Is there evidence of incorrect land application? If yes , check the appropriate box below. D Yes 0 No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu , Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidenc e of Wind Drift 0 Application Outs ide of Approved Area
12 . Crop Type(s): C.~ tJt~"-lO ftc ( ~'\ .~P6\)!==~ ~ .G .O·
13. Soil Type(s): \.J~%9-~ \)
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 inigation design or wettable
acres determination?
Page2of3
DYes
DYes
DYes
DYes
DYes
DYes
DYes
00ther:
0 Yes
Q!No
[3'No ~0
gNo
G{No
~0
[i('No
[i'N~
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
1/4/1011 Continued
-~~----------~~------~ !Facility Number: 'R~ -La~'\
r ' 24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box( es) below.
0 Yes [J'No
0 Yes 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 offrrst survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other:
DYes QNo DNA ONE
0 Yes 0 No MNA 0 NE
0 Yes ct No 0 NA 0 NE
0 Yes g'No 0 NA 0 NE
0 Yes (3'No 0 NA 0 NE
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 representative?
34. Does the facility require a follow-up visit by the same agency?
DYes 0No
0 Yes [;tNo
0 Yes 62fNo
DNA ONE
DNA ONE
DNA ONE
q ,9mments·(refer to question #): Explain anyYES answers and/or any additional recomme"nd8.titi~~\ot,_any ,otbericpin
Qse'dr8WingS:o_r facility to better explain situations (use additional pages as nec::essary). .. ,-~;t:A .. ?:~{t~41t . · <' ,·: · '::~.:1~~
"':'· -~
"'"" .
.-•l · -. .
1t-LJt.\\ ('t\~"~"i..b ~~~ .........
4 l'-\~U) S\uc:\~t.. SuRV£.'\ ()Gr"E... ::r" ~\~
~ \'.l~E-0 S.CJ:' S &:lim r\l!. .. Ooi'\L :X.t-. ~0
~ (?,II)(:)(:) I w 't\\ fe'C.:S..N \ ""''L"'El:> ~O.lV".
*--~~N:>s Cl~~().('.1.L'i:..0 ~\\ \<tfT·
Reviewerflnspector Name: Phone: C\\u--~·~rei
Reviewer/Inspector Signature:
Page 3 of3
Date: _c,.:.f-)Jo::.:6?5""-J,_l)-__ _
2/4/2011
Compliance Inspection Operation Review 0 Structure E\·aluation 0 Technical Assistance
Reason for Visit: OYRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ICfhYII! I Arrival Time:IIJ',OSAtf
Farm Name: ~ob{rt n...ilfr
DepartureTime:hi};~J>f'J I County:.50,fifll
Owner Email:
~ Region: 1 ~
Owner Name: Robtrf-"~tvc.p (I 6vi Hr Phone:
Mailing Address:
Physical Address: 3~{, Pak. fti_ J f Orf b{)" ()
Facility Contact: Brvlf P,vi I~ Title: () 'rr nf I'
Onsite Representative:
f\0 L~:-''n. .. :D" ;J .+t.J),. Certified Operator: l( vtf'_l D!."'~ D./I JL
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation?
Di s charge originated at: 0 Structure 0 Application Field
a . Was the conveyance man-made?
0 Other:
b. Did the discharge reach waters of the State? (If yes, not ify DWQ)
c. Wha t is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: -'t}-'---'8""'------------
Certification Number: q~JOS ~~~~------
Certification Number:
Longitude:
0 Yes ~No DNA ONE
O Yes 0No DNA ONE
DYes 0No DNA ONE
d . Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE
2. Is there e vide nce of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
0 Yes ~No
8Yes ,No
\}V
DNA ONE
DNA ONE
1141101 I Continued
JFacilit)' Number: I Date oflnspection: 9/N/'1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): _..~...19......._ __
Observed Freeboard (in): _c..-_~....,;3--'---
5. Are there any immediate threats to the intet,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 D No D NA D NE
Structure 5 Structure 6
DYes ~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 DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required butTers, setbacks. or compliance alternatives that need
maintenance or improvement?
~Yes 0No DNA ONE
DYes ~No DNA ONE
D Yes l5a No 0 NA 0 NE
DYes !Sd"No 0 NA D NE
II. Is there evidence of incorrect land application? lfyes, check the appropriate box be low. DYes ~No 0 NA D NE
0 Excessive Ponding D Hydraulic Overload 0 Froze n Ground D Heavy Me ta ls (C u, Zn, etc.)
D PAN D PAN > 10% or 10 lb s . 0 Total Phosphorus D Fai lure to Incorporate Manure/Sl udge into Bare Soil
D Outs ide of Acceptable Crop Window n Evidence of Wind Drill D Application Outside of Approved A rea
if~
12 . crop Type(s): Coo sta I Betm~-da Ht1~ ~~ gra(n Over reeL
13. Soil Type(s): ....!.W.!.Jolo!...lrjif-lr:u.olli.L.!m'l-I.I..J.S'------------------------------
I4. Do the receiving crops differ from those designated in the CAWMP? 0 Yes r8J No 0 NA D NE
15 . Does the receiving crop and/or la nd application si te need improve ment?
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage. for land application?
18. Is there a lac k 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 Dcheckl ists D Design 0 Maps D Lease Agreements
DYes
0 Yes
181 No 0 NA 0 NE
~No DNA ONE
D Yes l)a No 0 NA D NE
DYes ~No DNA ONE
DYes &J-No DNA ONE
DYes ~No DNA ONE
00ther:
21. Does record keeping need improvement? If yes, check the appropriate box below. DNA D NE DYes ~No
0 Waste Application 0 Weekly Freeboard D Waste Analys is D Soil Analysis D Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking D 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 IBJ No 0 NA 0 NE
23 . I f se lected, did the fa c ility fai l to in sta ll and maintain rainbrcakers on irrigation equipment? D Yes 0 No ~ NA 0 NE
Page2of3 214/2011 Continued
I Date of Inspection: 9 JNI11
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes ~No DNA ONE
D Yes ~No D NA D NE
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus 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.
0 Application Field D Lagoon/Storage Pond D Other:
DYes
DYes
DYes
DYes
DYes
DYes
RJNo DNA ONE
0No ~NA ONE
"fid No DNA ONE
~No DNA ONE
~No DNA ONE
fjiNo DNA ONE
----------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes l8No DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes ~No DNA ONE
Oofu•o3uur,t;, .... J.,, .... ,....11' .. ""' any YES answers any
situations (use additional
fr P~D;e. Yvo--~,0," Sfatllh l~oOJ rvat~!J.ftw/vctr-stftlttfq_rnvfdld Ci'et!> tn
HfitA b.-~ I+ tvor d 15' r'f td ~ iOM Jo, Gf»Jjob ofdeo, 0J dPI:r II o.i offf}OO? !
Jl, t.;Jl-soJI 'kff--fnr QDII a11d_ slvd.je. s"'j, Soil o.o~<J1kit1'W-G;r ~~
Yv9.S d ~ fn QOfO,
~Jt Sl "t/Je. 611rVf'; ~ 1 I" oi-tJ, 'I '1 lfJ -fa /I ~ ;)0 I 0, 'rvhfh 11-~'/s rJ f. '/o O~ SO J y 0'-' "'/ //
ood it> ~le 0-S(~e_ POA ¥\ti:ftnn qo dayJJ Otld cfea, tt ovi-11-rlh I~ ~ (Par.J,
}Jtnmvch {)~~Ole. ,Sev{!fll d~o#.Jtl1..'ov d veio PRI0 OuL:i(f~l/lotltmrJ~.Trvo~11 t~q~Q ,. 1 u '-u u h0t1eJ YV&--e J rehvl rr-.
Reviewer/Inspector Name:
Revi ewer/In specto r Si g nature:
Pag el of3
Phone: 'f I D--lf33-33a> (ll6c9
Date:,y,p I~ 110/1
21412011
.«J
..
Facility No_'b ()-fOlf Y Farm Name Rob:ri t30"&?:
Permit lL COC V OIC_ NPDES (Rainbreaker PLAT Annual Cert)
Pop. Design Current FB
Type
Lagoon 1 2
Spillway
Design freeboard
Observed freeboard (in)
Sludge Survey Date IOiq(l()
Sludge Depth (ft)
Liquid Trt. Zone (ft)
Ratio Sludge to Treatment Volume
Calibration Date 1 OfQIIA 2 3 4
Design Flow X}q
Actual Flow a31
Design Width ~d.h
Actual Width ~-l-
Soil ~est Date I}(>RJ.lt( ,~:Jo~/e._ Wettable Acres
pH F1elds
Lime Needed ..... hJ"'..o'----
Lime Applied
Cu-I ~ Zn-1 \../"
NeedsP
Cro Yield
Pull/Field
p~
l9J
f'i
fq
Soil
Y'vo8
'v
Crop
fJ3JiaJSaa< I ._/
I.V
Verify PHONE NUMBERS and affiliations
---
Acres PAN
?,h ~Yr-]q-()
14,q
37
~,0 ;. v
Date last WUP FRO Date last WUP at farm
FRO or Farm Records <6) \l) {)J
Lagoon#
Top Dike '-\!<(} ...s. Mt
Stop Pump'-\':).)/ -II..D.._)'~ ,c_,.l}
Start Pump L\'),3 },l \v1 ~h(),.~ 1 · '> 111 f'OYr'll
Conversion-Cu-I 3000= 108 fb/ac ; Zn-1 3000 = 213 lb/ac
I I
3 4 5 6 7
5 6 7 8
RAIN GAUGE
Dead box or mcmerator __ _
Mortality Records
Window Max Rate MaxAmt
1-ltY-)f,P/ a-t-Htv-
'I
q
App. Hardware ;
�1�15 7VS lalloltp
Type of Visit Q-Compllance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit V Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Dale of Visit: ArrrivaaI Time: —WiDeparture Time: ® County: S2W&
Farm Name: pf) be -f Rot kqP Owner Email:
h [� n 1
Owner Name: �0 � P1 rte U7VI 1"°/- Phone:
Mailing Address:
Region: EP D
Physical Address: t� » /�
Facility Contact: kfvrP 1�/I I?/" Title: C/F1A'W Phone No: 6+&MT
Onsite Representative: 1�/V(� hhI'�/` y� Integrator:
Certified Operator: Ro�'t D. hor Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
to Finish
Farrow to
Other
❑ Other
Back-up Certification Number:
Latitude: Do =1 =U Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
In r�2� ❑ Non -La er
Dry Poultry
❑
Layers
❑
Non -Layers
❑ Pullets
❑
Turkeys
❑
Turkey Poults
❑ Other
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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ETI
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?
❑ Yes I No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes (�i No ❑ NA EINE
❑ Yes b?'No ❑ NA ❑ NE
12128/04 Continued
1I

~Facinty Number:1;;}.. -6?'tV I Date of Inspection IIA.h. ll 0 I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes l;itNo 0 NA 0 NE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:---------------------------------------
Spillway?:
Designed Freeboard (in): _ __,;,l_.SI----------------------------------------
Observed Freeboard (in): _ __;~=--..:tt?~--------------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes ~No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes 3'No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
~Yes 0No DNA ONE
0 Yes l£CNo 0 NA 0 NE
DYes ~o DNA ONE
DYes ~No DNA ONE
II. Is there evidence of incorrect application? If yes , check the appropri ate box below. DYes ~No DNA 0 NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc .)
D PAN D PAN > 10% or 10 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outs ide of Acc eptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12 . Crop type(s) Co tria) '&rmv</o._ lly Q. PtJrfwe; Small ganb 0L1f!Jf'ft1..
13. Soil type(s) )\b B \ s ... (»lb\fu S BoB )
14. Do the receiving crops differ from those designated in the CAWMP? 0 Yes iid"No 0 NA 0 NE
15. Does the receiving crop and/or land application site need improvement? DYes 181 No DNA 0 NE
16. Did the facility fail to secure and/or opera te per th e irrigation desi!,'ll or wettable acre determination ? 0 Yes 1)1' No 0 NA D NE
17. Does the facility lack adequate acreage for land application'?
18. Is there a lack of properly operating waste appli cation equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 2 of 3
D Yes ®No DNA ONE
DYes ~o DNA ONE
1· Facility Number: l{;~ -b ~YI Date oflnspection hd lalt 0
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 D Checklists 0 Design D Maps D Other
DYes [S(No DNA ONE
DYes !StNo 0 NA D NE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No 0 NA D NE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
D Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and 1" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes 0No ~NA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes 9No 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 gNo DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 0No ~NA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes R'No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes 18tNo 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 Dl"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 IS!J-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 .~0 DNA ONE
33. Does facility require a follow-up visit by same agency? DYes 12tNo DNA ONE
Page 3 of 3 12128104
• Fa~ility No. ~d:(oYV Farm Name ~obrt ~vf(f/' Date _____ _
Permit / COC OIC~ NPDES (Rainbreaker PLAT Annual Cert )
Pop. Design Current
Type
Lagoon
Spillway
Design freeboard
Observed freeboard (in)
Sludge Survey Date
Sludge Depth (ft)
LiQuid Trt. Zone (ft)
Ratio Sludge to Treatment Volume
Calibration Date 1 2
Design Flow ~w
Actual Flow ~
Design Width 3d"
Actual Width )Q~
Soil Test Date ,~if r-
Pull/Field Soil Crop
h roe, 1* !so
I
'f; q
1 2
I In'" I liD !../,~· ~
.:h-o,ttC/
3 4
Wettable Acres ~
WUP ----Weekly Freeboard -1...-L.
1 in Inspections V
120 min Insp. V
Weather Codes ._,
Transfer Sheets
Acres PAN
C}!lr /'60
-i
'\ "
Verify PHONE NUMBERS and affiliations
Date last WUP FRO~/fCP(o_s-Date last WUP at farm
FRO or Farm Records
Lagoon#
Top Dike
Stop Pump
Start Pump
Conversion-Cu-I 3000= 1081b/ac; Zn-1 3000= 213 lb/ac
I I I I
3 4 5 6 7
5 6 7 8
RAIN GAUGE \..,./
Dead box or tnctnerator __ _
Mortality Records
Window Max Rate MaxAmt
I HJ-~+ . &i-J-W v J
•
App. Hardware
Type of Visit ~mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~ne 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
DateofVisit: l1o-2o-c19l Arriva1Time:l9:2otlhct I DepartureTime: I/0/3'-f~.l County: .sa~RS"A.I Region: rP(;/
Farm Name: f3u+/q f-tt.vHA 5 .:t"uc.. Owner Email: ----::=-~-=-------
Cc-t/ q9o .)7 3 o
Owner Name: Rq/:,~..r f Ba 1/t:r Phone:
Mailing Address: @rem HI,.,
Physical Address:-----------------------------------------
Facility Contact: -----------------Title: ------------------
PhoneNo: _____________ __
Onsite Representative: ----------------------Integrator:-------------------------
Certified Operator: Operator Certification Number:
Back-up Operator: ----------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D"
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field 0 Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notifY DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude: D OD'D"
DYes ~DNA ONE
0 Yes 0 No [3'W.,. D NE
DYes 0No ~ONE
I
d. Does discharge bypass the waste management system? (lfyes, notify DWQ) DYes 0No ~A ONE
0 Yes B"'N"o DNA D NE
DYes ~DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
12128104 Continued
I Facilif)· Number: 92 -(, 9'11 Date of Inspection llu-ziJ~of I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
DYes ~ DNA ONE
DYes ~ DNA ONE
Structure 5 Structure 6
Identifier: ___ .P-__ 1 ___ ----------------------------------
Spillway?:
Designed Freeboard (in): -----------------------------------------
Observed Freeboard (in): __ 3:=;.....:::[3 ___ -------------------------------
5. Are there any immediate threats to the intq,rrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes ~DNA ONE
DYes ~ DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental th~, notify DWQ
7. Do any of the structures need maintenance or improvement? 0 Yes 8"No 0 NA 0 NE
8. Do any ofthe st uctures lack adequate markers as required by the permit? 0 Yes ~ 0 NA D NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Arc there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
II. Is there evidence of incorrect application? Ifyes, check the appropriate box below.
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn , etc.)
D PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12. Crop type(s) _...&8.~~::!:....!:-~i4~....::J~..,_~-1G...L~qr_.L) ;r--~£:!:""~'i-:!;..!t/!:!.,._~a::...:..-c.:....=.:....•'!:::,.J:....__...:.(......:o:...__' ~-·...:_):...__ __________ _
13. Soil type(s) Wa....B
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
. -·
Comments(refer to qu1estiion
drawiligs :(,r facility to
G {TO cL ~r--._ ~
&ov d_ ~c.~d 5 I
~t:l z_J~. zz3~ .
'/)a.N T3 c,; I e. y Cow lcJ v J <-.,u._,~s. ;:;:;. ,...._ ~
Reviewer/Inspector Name
Reviewer/Inspector Signature:
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~0 DNA D NE
DYes ~DNA ONE
DYes ~DNA ONE
12/28/04 Continued
•. .
I Facility Number: f3 2 -m Date oflnspectioo l/o-20-o91
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box . 0 WUP 0 Checklists 0 Design D Maps 0 Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
DYes ~ DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Annual Certification
D Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
· 23 . If selected, did the 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 facil ity fail to have an actively certified operator in charge?
27 . Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than nonnal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notifY the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does fa cility require a follow-up visit by same agency?
DYes ~ DNA O NE
D Yes ~ DNA ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
D Yes ~DNA ONE
•
11128104
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
DateofVisit: ltniJikJi I Arriva1Time:lf~"J0f"11 DepartureTime: !OI~/Sflfl County:~SD-) Region: P fl 0
Farm Name: Robtft n..,trt: Owner Email: ------------
Owner Name: Roba-:t Br t/c:f, ___;;,B_vf-~W~------Phone:
Mailing Address: 51 I Mile Cltwfh RJ__
Physical Address: -------------------------------,.;:-:--:-r-:-= -.,...----S(p'l""tRJ~-1)
Facility Contact: Phone No: 9ftrn3 '-1-C
Integrator: H vrrly-Brol!n (~nPttft,:!f9
Operator Certification Number: AllfA ~ 'J()s=
Onsite Representative: ------------------
Certified Operator: RoOt;.-tB.
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? DYes ~o DNA ONE
Discharge originated at: 0 Structure D Application Field 0 Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (lfyes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes K'No DNA ONE
DYes !K"No DNA ONE
12128104 Continued
· I Facility Number:?)~ -ft,'{'f I Date of Inspection lmltaltil I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) Jess than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:-----------------------------------------
Spillway?:
Designed Freeboard (in): _..._,Cf~---------------------------------
Observed Freeboard (in): __.Qlox-~w....---------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes 'f)a"No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed 0 Yes "" No 0 NA 0 NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and tbe situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8 . Do any of the s tuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste AppUcation
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement? .
fil"Yes 0No DNA ONE
DYes ~No DNA ONE
0 Yes ISfNo DNA 0 NE
DYes IX.No DNA ONE
11. Is there evidence of incorrect application? lfyes, check the appropriate box below. 0 Yes !1fNo 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Eviden ce of Wind Drift 0 Application Outside of Area
12 . Crop type(s) Co tiM I Bet,..d.t_ ( H t S Cb fJS
13. soil type(s) ~w~a5....!Blo!._.J.J ~$' ___________________________ _
14 . Do the receiving crops differ from those designated in the CA WMP? DYes eNo DNA ONE
15. Does the receiving crop and/or land application site need improvement? DYes ~No DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation des ign or wettable acre detennination?D Yes fgNo DNA ONE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Pagel of 3
.. ~:·•.
D Yes 5i No 0 NA 0 NE
DYes &tNo DNA ONE
11118104
j Fa~ility Number: ~d. _,4yl Date of Inspection lmlf!tof I
Reguired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily· available? If yes, check
the appropirate box. D WUP D Checklists 0 Design D Maps D Other
DYes fiiNo DNA D NE
DYes ~No DNA ONE
21. Does record keeping need improvement? Ifyes, check the appropriate box below. DYes fit No DNA D NE
D Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and I" Rain Inspections 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 0No ~NA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes !)a No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes !Sa No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes 60 No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 0No IB'NA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes 'tia 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 '6(t 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 gf'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 IX No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE
7; Re~.Je.-see:Lq.,.,l e.. .sF tn i"r;d'fDfii{JDtn ft4fls
J<i. C:zli.LrttftL a.oo~>. 11 tv;ll niel.. -f.v calilrnk_ +"'"r )"4r
A-Pfii~L lfl»'tef, Hat~, O>OOf JaF'ftYSDII s.,rv;r
Good ii11~ Q. recotdJ
Page] of 3 12/18104
• Fatility No. ~).--b'i'-( Time In \~~30 Time Out ___ _ Date 1/f~ for
Fann Name llobei--lrlttb Integrator-----------
Owner -----------------Site Rep-----------
Operator No. _______ _
Back-up No.--------
COC \../ Circle: General or NPDES
Design Current Design Current
Wean-Feed Farrow-Feed
Wean -Finish Farrow-Finish
Feed -Finish Gilts I Boars
Farrow -Wean Others
IQ "'\CA p~=-1. IC
FREEBOARD: D$1ig~ -~OLI'' err-q, ) Observed f1 c ~ ~..,;____,) '----_;;_-IJ....J IJt. w .. '~ Sludge Survey ' lt' la!J')\(fj L 17t=-3·~ Calibration/GPM __10l' I )Sl. f(~ ··~
Crop Yield _./' Waste Transfers ~Qjf""l V &!11· R:tc~ Rai~£ruge ~-___,~ ~rhecl.J ffJ'Je, 31 ~ Rain Breaker___ -r#· ·qi)t)
SoiiTekt@ ·. WettableAcres ~ PLAT_____ .5\?J.::-lfS.J
Weekly Freeboard ./ Daily Rainfall .../ 1-in Inspections / ~.:-~~ -------~-----=--=--==== }'lj_((. -Vh.n Spray/Freeboard Drop "'\ f r
Weather Codes / 120 min Inspections _/__ ~,
Y3 ~s:ttJr rHtr Waste Analysis:
Date Nitrogen (N) Date Nitrogen (N) 1.3-.;:
/.s-f. 0
Pull/Field Soil Crop Pan Window
"' )r~cr
tJ i'l
c; l:v.
~ ~
~11)1
Type of Visit ~Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: I ~ (p { Ol I Arrival Time: I } ~ 00 I Departure Time: I J County:~ Region: F£..JJ
Farm Name:~~+ 8cuce. fuJ,k_t' f='Glyrv--Owner Email:------------
Owner Name: f!Jx-v..e.g ......:~::....<. -==u.'--.j;l.w.=...&...-__ _ Phone:
Mailing Address: -----------------------------------____ _
Physical Address: ----:::-------=----------------------------~~ -----
Facility Contact: ~ J k/ Title: Ov..J~( Pbone No:--------
Onsite Representative:e;:r ~(e.,. 6u /fey-Integrator: ~tyn Sfd
Certified Operator: 8rttct Bu14t Operator Certification Number: 9'17 3o$"
Back-up Operator: --------------------Back-up Certification Number:
Location ofFarm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes lflNo DNA ONE
Discharge originated at: D Structure D Application Field 0 Other
a. Was the conveyance man-made? DYes 0No ~NA ONE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No ~NA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No ~NA ONE
2. Is there evidence of a past discharge from any part of the operation? DYes ~No DNA ONE
3. Were there any advers e impacts or potential adverse impacts to the Waters of the State DYes ~0 DNA ONE
other than from a discharge?
Page 1 of3 12128104 Continued
!Facility Number:g._)...-/lllf I . . .. Date of Inspection ~
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
DYes ~o DNA ONE
DYes ~No DNA ONE
Structure 5 Structure6
Identifier: ___ 1 ____ -----------------------------------
Spillway?:
Desib'lled Freeboard (in): --'-{g..._ ____ -----------------------------------
Observed Freeboard (in): 3/ _.....;;:;;....:._ ___ _
5. Are there any immediate threats to the integrity of any of the structures observed?
(ic/ 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 DtNo DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or em•ironmental threat, notify DWQ
7. Do arty of the structures need maintenartce or improvement?
8. Do arty of the stuctures la ck adequate markers as n::quired by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
DYes ~o DNA ONE
DYes ~No DNA ONE
9. Does any part of the waste management system other than the waste structures require
maintenartce or improvement?
DYes ~No DNA ONE
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes
II. Is there evidence of incorrect application? If yes, check the app ropri ate box below. 0 Yes
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
~No DNA ONE
~0 DNA ONE
0 PAN 0 PAN > 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Croptype(s) ~m~ i/ J ~ Gr
LYv6 I 3. Soil type(s)
14. Do the receiving crops differ from those designated in the CA WMP? DYes J9No
15 . Does the receiving crop and/or land application site need improvement? DYes .}sNo
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?O Yes i§.No
17. Does the facility lack adequat e acreage for land application? DYes ¢No
18. Is there a lack of properly operating waste application equipment? DYes ptlNo
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):
12128104
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
{Facility Number:<&;i 3Jf41 Date ofln•pecdon ~
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. D WUP D Checklists D Design D Maps D Other
2 I. Does record keeping need improvement? If yes, check the appropriate box below.
DYes 9QNo DNA ONE
DYes IRNo DNA ONE
DYes l8fNo DNA ONE
0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers D Annual Certification
0 Rainfall 0 Stocking 0 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
Additic)~al~omments and/or Drawings:
-'F ~ bo..l\J... c;....p:rf ~' ~
~vVJ-oeA"D~ 1..------
~:c..~ tJ-uV\' u~J~ .,u~.
Pagel o/3
DYes ~No DNA ONE
DYes l:n,No '}(NA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes li,1No DNA ONE
DYes 0No ~NA ONE
DYes ~No DNA ONE
DYes ~0 DNA ONE
DYes }'JNo DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
11128104
~~·· ~~~Y No. '© ~ lj Lj Time / {) diJ
l -~arm Name~-{ b1M_~ f.x.ct&l rQ.y_-/
Time Out Date 8 I & / <f7
Integrator fJ/lp~~ J_p I ~ 1
) ' Owner f.YL: u
Operator JSii).{(J S~eR~ ·~~
No. Jf7 ~f7J))
Back-u p -~ No.
coc_ Circle : ~ Genfj or NPDES
Design Current Design Current
<::: "Weaa......: Feed ) ln YOU ..,._
vv ~
Feed..-Finish
Farrow-Wean
FREEBOARD: Design ~---­
Sludge Su1vey __ v_~_-· __
Rain Gauge .
titS ~<..
v
cropYield ? .. V .
Soil Test PLAT ------
Weekly Freeboard ___,_ __ _ Daily Rainfall -····
Farrow-Feed
Farrow Finish
Gilts I Boars
Others
Observed -------..... ...__-'( J. )0 Calibra!km/GPM
Waste Transfers----
Rain Brea~k~er"======--
Wettable Acres l ./'.
1-in Inspections ____ _
Spray/Freeboard Drop -----------------------
Weather Codes __ _ 120 min Inspections __ _
Waste Analysis:
Date Nitrogen (N) Date Nitrogen (N)
1.< 7.2
/.Cl
Pull/Field Soil Crop Pan Window
1\ () /1 I J .L.. Ml r
\ ll~ ') v'-7-·t h-.. H dV~ Jlf4v-~
I --(' "" h ' l?/( y.[) Oct--fl1 b/
)'' f/ 1..1
---------c:::::::----r-----I' / --.::::._~
I..J d-'-----lc::;J'L:{~/0. "'=::...i~ -::::: ~ --------~ -~ ..... , ·-.... ·--~
~ ..
tv£-r-;-~~ ~I/"-{ ~
. ·---1--I
,
Type of Visit ~ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I to I r9f ~~ Arrh'al Timed/ p ~ 9'..1. I Departure Time: I /ISle I County~ Region: ~ £.0
FarmName: ~\aa.r.\ bu.fur (&v-\A.~~J OwnerEmail: -----------
OwnerName: RohPx4-_;::~~~..>...:.kt-~----Phone: '\(i) Slo~ ic~1J 9qo)13~ ("")
Mailing Address: 5 '11 Zc::Af Chut ~ RcL
Physical Address: J ~ (p P lt f-e 1<d.
-=~~· ~\a<...l....!m~iw..~r 'tf-----_.;:~~ ~~-~5'2.
~ f?o s-ebor/J cJ 83 ~ :r
Facility Contact: ----'~~=-.;...:.€...=--------Title: -----------Phone No: _____________ _
Onsite Representath'e: ---.S~Q::.......:m....!...!._,(....or:::::..._____________ Integrator:-----------------
Certified Operator: f<ol::::»_,~:f ..c.iJ>....LI<u:1...J~/v=--------Operator Certification Number: q R f 3 0~
Back-up Operator: ---------------------------Back-up Certification Number:
Location ofFarm: Latitude: D Oo·ou Longitude: ooo· Du
.
~12. l L. 3'\ (Po.-4~ ~) • \?:,~n NC~4 L""~. '\ a ,·1'\..t-()"") 1 SL (Vfo (r:-te<-4 Cei¥re;~ ...
l'leox ~~rei 1:1
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
ID Wean to Finish I I lj 10 La~er I I [ ODairyCow I
I
~Wean to Feeder ~'-/oD '51, .i'1 :0 Non-La~er 0 Dairy Calf I
0 Feeder to Finish ---. ... -.. ·---0 Dairy Heife1 i
0 Farrow to Wean Dry Poultry OD_IYCow I
0 Farrow to Feeder 1 0 Non-Dairy
I 0 Layers 0 Farrow to Finish I
!
0 Beef Stocker
0 Non-Layers 0Gilts I D Beef F ceder
0 Pullets I 0 Boars I I 0 Beef Brood Cow _j . -.!1 0Turkeys
I
-... -----~--I -.J------------! Other-r.,;.. D Turkey Poults ','.::r.o"
'
ID Other I ---J ~ 0 Other ! Number of Structures: I __ j ~ -----·-· .. --""' ---.. ----.. ·-
Discharges & Stream Impacts
L Is any discharge observed from any part of the operation? DYes .£!(No DNA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other
a. Was the conveyance man-made? DYes 0No ~NA ONE
b. Did the discharge reach waters of the State? (If yes. notify DWQ) DYes 0No -f&NA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
DYes 0 No _.J4NA ONE
DYes )&No DNA ONE
DYes ~0 DNA ONE
11/28/04 Continued
I Facility Number:~l_ -f.?L/-f I Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes ~No DNA ONE
DYes 0No ~A ONE
Structure 5 Structure 6
Identifier:------------------------------------------
Spillway?: ·,n " Designed Freeboard (in):----,:.....'--------------------------------------
Observed Freeboard (in): __ 7!:._~....:....-ll ___ ---------------------------------
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 'fi{No 0 NA 0 NE
DYes ~o DNA ONE
If any of questions 4-6 were answered yes, and tbe situation poses an immediate public bealtb or environmental tbreat, notify DWQ
7. Do any of the structures need maintenance or improvement? 0 Yes "":2tN o DNA ONE
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks) DYes ~No DNA ONE
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement? DYes ~No DNA ONE
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes 'ftNo DNA ONE
II. Is there evidence of incorrect application? lfyes, check the appropriate box below. 0 Yes '&fNo 0 NA ONE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
12. Croptype(s) &f"murh -H~ l SmJt Grc:U11 Dverw£
13: Soil type(s) WQ&Iam {WA..t3)
14. Do the receiving crops differ from those designated in the CAWMP? 0 Yes ~No 0 NA D NE
15. Does the receiving crop and/or land application site need improvement? 0 Yes ~o 0 NA 0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination!O Yes ,No DNA 0 NE
17. Does the facility lack adequate acreage for land application? 0 Yes ~No
18. Is there a lack of properly operating waste application equipment? 0 Yes
Reviewer/Inspector Name
Reviewer/Inspector
... .
12118104
, '.
I Facility Number: 8 2 -idfll
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP 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 ~No DNA ONE
DYes~o DNA ONE
DYes ~No DNA ONE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification
0 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the in spect ion did the facility pose an odor or air quality concern?
If yes , contact a regiona l Air Quality representative immediately
31. Did the facility fail to notifY the regi onal office of emergency s ituations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33 . Does facility require a follow-up visit by same agency?
' ('
•
DYes ~No DNA ONE
DYes 0No~A ONE
DYes 'Jl{No DNA ONE
DYes 1it.No DNA ONE
0Yes~No DNA ONE
DYes ~No DNA ONE
DYes ~0 DNA ONE
DYes ~o DNA ONE
DYes ~0 DNA ONE
DYes {BNo DNA ONE
DYes &a No DNA ONE
0Yes ~No DNA ONE
··;;~~~~,~~
~
12128104
Compliance Inspection 0 Operation Review
Reason tor Visit ~utine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access
L._ __ F_a_ci_li_ty_N_um_b_e_r _1_8'_:J __ H __ ,_w ____ __,l Date or Visit: I 4-/~9/iATune: I l: ~ -. lo Not Operational 0 BeJow Threshold
~nnitted ~:!~"Certified C Conditionally Certified C Registered Date Last Operated or Above Threshold: .. --·-·-.. ·---··
Fann Name: ····---~!-:J.~---·--f.~!:.9:.~.'!t.................................................................... County: -·---~-----------··-·--·-·--·
Owner Name: ___ Y-!.~ ___ ft.;,.~ ~--·-··---·-·--·--·---··---·---·-·· Phone No: .. Jlrt.::: . .S.. 'I~ -:.-'e.iL. ..... ----·--··---·-·-·-·
Mailing Address: ........ 11fi. ........... r:!.£'!.J.t.Jl.. ..... L9.9.f-....... £J ... __________ --~.k ....... t:J.L _____ ~!Jg ~ ·--·--·-·
Facility Contact: ----~~--~~---···-----·--Title: ·--·--l2.~.!!.~~-----··-··--···--·· Phone No: -···----·-·------·---·····
Onsite Representative: .............. ~~-C:. .............. f.~~~J~.~---··-·-·-·---·-··---·-·· Integrator: __ J..r-e-.;-. ... ~'ft.ra..,J~------
Certified Operator: ·--~4!:!£!1 ___ ~.: .... ___ .£'!Jr. ttl~.---·--·-·-····-·-Operator Certification Nmnber: ... .lCr..l.t!.J: ........ _. __ _
Location of Farm:
~ine 0 PouHry 0 Cattle O Horse Latitude ...._ _ _,!• .._I _ _.I• ._j _ __,j•• Longitude .______.I• 1-l _-..~I· 1-l --~'"
E:;;:;:....~-=-~-:-~-~-:-eed-e_an_er-+----+----~:l~b c);b;; ·-.. -:f ,, ..
~-----+-----1---~ 'dt"~£ ' :._:' ·-:~;~t;i:~,~~;,~-_;"~ .. : ~=====~
-·" . . . :·; :~~~~~j~·:-: T_otilSSE~.:.d
II
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at D Lagoon 0 Spray Field D Other
a. If discharge is observed, was the conveyance man-made·?
b. If discharge is observed, did it reach Water of the State? afyes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gaVmin ?
d. Does discharge bypass a lagoon system? ar yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? D Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
I den li fier: -·-···-·-.J-·-·-·········
Freeboard (im:hes): __ '/-L....Jl/-..__ __ -------------
12112103 ------
DYes @'No
DYes DNo
DYes DNo
DYes DNo
DYes [il1ilo
DYes ~0
DYes ~
Structure 6
Continued
'fFacilitY Number: ~:l -'qqj Date of Inspection I 'f/:11ft,IJ
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelinwrovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
II. Is there evidence of over application? If yes, check the appropriate box below.
D Excessive Ponding D PAN D Hydraulic Overload D Frozen Ground D Copper and/or Zinc
12. Crop type [~rt'\C,Qs$1 ~If y-w p~ ('¥=1 o~L--k)
13. Do the receiving crops di er With those designated m the Certified Ammal 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 l-;sues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18 . Are there any dead animals not disposed of properly within 24 hours?
19 . Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
DYes ifN"o
DYes ~0
DYes ~0
DYes ~0
DYes ~0
DYes ~0
DYes [!(No
DYes ~0
DYes [ti'No
DYes lirNo
DYes ~0
DYes !if No
DYes E(No
DYes ~
DYes ~0
DYes ~0
DYes l!f'No
~~E4Sit~~ltWJ~~~~~::g~·~~
•
Date:
12/12/03 Continrud
• J Facility Number: ~ ~ _ C,#f Date of Inspection I j/9-tt / olf I
Required R~ords & DocumenLo;
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
0 Waste Application 0 Freeboard 0 Waste Analysis 0 Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified A WMP?
I\"TDES Pennitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
0 Stocking Form 0 Crop Yield Form 0 Rainfall 0 Inspection After I" Rain
0 120 Minute Inspections 0 Annual Certification Form ,
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
llif No violations or deficiencies were noted during this visiL You will receive no further correspondence about this visiL
• ND -•l•~ ~c.o~~ l 4ry $.-; / ~'t-S .
..., ~te lJ.-.. ~II J~~,x. ~)'.rcl •• d'tt.. ~ J 4
-&tk, lA ~ Ht) ~a-~.
~No (01bl~~.
12112103
l"t'C.
~0
[B'No
~
~0
~0
gNo
~0
[!~'No
~0
ifNo
DNo
DNo
DNo
DNo
DNo
• t--
-....
' ..
Type of Visit e Compliance Inspection 0 Operation Review ' 0 Lagoon Evaluation
Reason tor Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification • Other 0 Denied Access
Time: Vo: I S" .4Jttl
IO l'ot Operational 0 Below Threshold
..._ __ F_a_c_ih_·~-· -~-u_m_b_e_r_l_a_'2 __ H ___ "_¥_¥._ ___ ..,.jl D:.tc of\"isit:
10-fermitted El-Certified [] Conditionally Certified [] R~istered Date Last Oper-ated or Above Threshold:
Farm !\ame: Coun~·: ~t'?J.RSP'l
Owner 1\ame: ~(. fi..•rdt?/-h,____________ Phone ~o: c;lo · 5"'1;2 (;.Oil/
Mailing Address: 13 ~s-frl.'ld,t/ L"o/' Rowf lfakbara ,. 1\/ ( ..7/$3$2
P?to
FaciJi~· Contact: ~)'a( Fa:c,/o fb
Onsite Representath·e: 1-v'b >'"' Fc«crla f6
Title: CJ w" f r Phone~o : ------------------
Integrator: &"' ;,.... ~,,/J
Certified Operator: .....,..IM...,z""")¥',aeUJIO. ____ r;_=t;,.><:L.I, ..... 'c_.£.._/. ... ~"-Q-------------------Operator Certification !\umber:
Location of Farm:
~
ISJ-Swine 0 Poultry 0 Cattle 0 Horse Latitude L----'1•1~....--_ _.l' L..l ----'1"' Longitude I• I I· I 1--
Design CW'rent Design Current Design Current
Swine Capadtv Population PouJtrv Capacitv Population Cattle C!l!acin· Pol!ulation
I I ~'ean to Feeder t, Lfoo (,()(:)() IDLaver I I I IDDairv I
D Feeder to Finish 10 Non-Laver I I I :o Non-Dairv :
Farrow to Wean
Dother I I I Farrow to Feeder
Farrow to F inish Total Design Capacity I
Gilts I 0Boars Total SSLW
Number of Lagoons I l I ID Subsurface Drains Present· ·10 Lagoon Are3
:Holdiug Ponds I Solid Traps I I ID !So Liguid Waste Management Svstem
Djscharoes & Stream Impacts
1. Is any discharge observed from any pan of the operation?
Discharge originated at: 0 Lagoon 0 Sorav Field 0 Other
a. lf discnarg: is observed, was the conveyance man-made?
b. If discharge is observed. did itreacb Water of the State? (If yes, notify DWQ)
c. If discharge is obsm·ed. 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 pan of the operation?
I
I
fD SJ!ra'· Field Area I
I "~~~~:;.~~~~~ ~ .· -
0 Yes IQ-iqo
DYes ~o
DYes ~o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste CQJiection & Treatment
4 . Is storage capacity (freeboard plus storm storage) less than adequate? 0 Spillway
Strucrure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: /
DYes 0No
Structure 6
Freeboard (inches):
05103101 ;41=1,/.J. '13 ~-~-----------------------------Continued
jFacility Number: $J.... -~4lj ] Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
seepage , etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and tbe situation poses an
immediate public bealtb or environmental tbreat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? 0 Excessive Ponding 0 PAN D Hydraulic Overload
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)?
14. a) Docs the facility lack adequate acreage for land application?
b) Docs the facility need a wettable acre determination?
c) This facility is pcnded for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. ls facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
24. Does facility require a follow-up visit by same agency?
W e any additional problems noted which cause noncompliance of the Certified A WMP?
c.< .slc:~f ,·~ 9 J,,•f( fl.~
&-fl"'.c""Js ,'n.sf7t~c.l~d
Reviewer/Inspector Name
Reviewer/Inspector Signature:
05/03101
C(
{..vi)~ tel a/lotv lc/Ci.sl~
,C,·{> lei a,.,cJ f'D17J
.5./U&-.y ~1/11 t.v.:-!>
fo ron ;..,-lo &(
and -/'o"/ld /lo
S.f'rc, 7 r :.,'3
_$4y ~ /01 /' 7
lvn·"~
Date:
DYes DNo
DYes DNo
DYes 0No
DYes DNo
DYes DNo
DYes DNo
DYes DNo
DYes DNo
DYes DNo
DYes DNa
DYes DNa
DYes DNo
DYes DNo
DYes 0No
DYes 0No
DYes DNo
DYes DNo
DYes 0No
DYes DNo
DYes DNo
DYes DNo
DYes DNo
t{,/(t_slt! 0.1)
ar~t:< Owq
of v~sie..
Continued
Facility Nu.mber:__§l_-644
General Information;
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
Date: 6/18/96
Time:l :45 p.m.
Farm Name: Wayne Faircloth (Faircloth Farm) County: Sampson
Owner Name: Wayne Faircloth Phone No: (~HO) 525-4759
On Site Representative: Wayne Faircloth
Mailing Address: 1355 Mitchell Loop Road
Integrator: Brown's of Carol ina
Roseboro, NC 28382
Physical Address/Location: Take NC 24 East from Roseboro, go a~roximately 5 miles aod
turn right onto Pate Road. Take Pate Road for a~roximately 1/4 mile
and turn right to hog farm at ·sign •
. .
Latitude: I I Longitude:
Operation Description: (based on design characteris1ics)
Type of Swine No. of Ani1111lb
OSow
3l Nursery 4 houses -a Feeder 1600 per house
Other Type of LiW!stock:
Typt! of Poultry No. of Aninuzl.s
OLayec
CNon-Layer
Number of Animals:
I I
Type of Caltk
ODairy
OBeef
No. of Animals
Number of Lagoons: 1 (include in the Drawings and Observations the freeboard of eacb lagoon)
·.
Facility Inspection:
Lagoon . . .
Is lagoon(s) freeboard less than 1 foot+ 25 year 24 J:tour storm s.torage?:
.Is seepage observed from the. lagoon?: ·
Is erosion observed?:
Is any discharge observed?
0 Man-m.tllk 0 Not Mon-'~Nl.t/.l!
Cover Crop
DOes the facility need more acreage for spraying?:
Does the cover '{rop need improvement?:
( list the crops which. need impiovemeru)
Orop~=·--------------------------~~ge :._· ______________ __
Setback CriJerill ·.
Is a dwelling located withiri 200 feet of wa5te application 1
·Is a well located within.lOOfeet of waste applicatio~? · ..
~ allimal wa5te stocG>iled .within 100 feet of USGS B~u~ Line Stream?
·Is aniina1 waste land applied or spray irrigated within 25 feet ofBfue Line Stream?
AOI-Juuary 17,1996
YesO Nol?:l
YesO No~
YesO Noij}
YesO Noij}
YesD No .~
YesO . Nol29
YesO ·No~.
..YesO .•No~
YesO No~
y~a No~
Maintenance
Does the facility maintenance need improvement?
Is there evidence of past discharge from any part of the operation?
Does record keeping need improvement?
Did the facility fail to have a copy of the Animal Waste Management Plan on site?
YesQ Nol3
YesQ Nor!
YesO Nor!
Yes 0 Nol2i
Explain any Yes answetS·._ -------------------------
S~: ·~
cc: Fadliry A.Jsusment Uftit
Prawines or Observations;
\
, 1 1/2-2 Acre Lagoon
in
Office ~· r.
Generator
Pump House
Date: 4//0/f.&
Use Attm:hments if NeetUd
:
•' .. --. . ··-..... .
....
This facility is well maintained and operated. The cover crop of Coastal .. · .. = ·
Bermuda has been sprigged and is overseeded with millet. The facility began
operation in mid February 1996,. and the lagoon has a freeboard in· exeess ·'Of 10
fe~t. All management and certification paperwork. are current. Mr •. Faircloth
has a:tre:ady taken and passed the test for operator certification. Th.is. farm
is well managed and couid be considered a model farm in the swine 'Uri8u8try •
. :.
AOI-January 17r!996
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