820645_INSPECTIONS_20171231

NORTH CAROLINA
Qepartment of Environmental Quality
0 Deoied Access
Date of Visit: I a-Q -J?l Arrival Timed I 0 :00
Farm Name: » 'rn :5 afu I -._5-
0wner Name: :fhe /TO !\t "$ ai±1'
Departure Time: I /eZ .'W I County:£~ R~ion: ~
Owner Email:
Phone:
Mailing Address:
Physical Address:
Facility Contact: ....~.·5'"-. ~h~~~~~....::--.:.:::]S:.......;.~~....:..-..e..5 __ Title:
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Dischall!es and Stream Impacts
I . Is any discharge observed from an y part of the operation? DYes ~o
Discharge originated at: 0 Structure 0 Application Fi e ld D Other:
a. Was the conveyance man-made? 0 Yes QNo
b. Did the di scharge reach waters of the State? (If yes, notify OWR) 0 Yes 0No
c. What is the estimated volume that reached waters of the State (gallons)?
d . Does th e di sc harge bypass the waste management system ? (If yes, notifY DWR) DYes 0No
2 . Is there evidence of a past di sc harge rrom any part of the operation?
3 . Were there any observabl e adverse impacts or potential adverse impacts to the waters
of the State other th an from a di sc harg e?
Page I of3
0 Yes ~No
0 Yes (;&No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
11412015 Continued
'!Facility Number: loateoflnspection: ttfl.~IJ-t?
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 I Structure 2 Structure 3 Structure 4
Identifier: L lot t. Lo;;;_ i-.OJ-.01 '--3 '() l
Spillway?:
Designed Freeboard (in): i"'T L9-19-JCf-
Observed Freeboard (in): d-J?" d.~ ,3_1) '-}T)
5. Are there any immediate threats to the integrity of any ofthe structures observed?
(i.e ., large trees, severe erosion, seepage, etc.)
6. Aie there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes 5-No DNA ONE
0 Yes 0No DNA ONE
Structure 5 Structure 6
1-'10 I L ijO;L
/~ L.?'-
~ ~
0 Yes ~No DNA ONE
0 Yes IK'! No DNA ONE
If any of questions U were answered yes, and tbe situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits , dry stacks, and/or wet stacks)
9 . Does any part of the waste management sys tem 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?
D Yes RJ No 0 NA 0 NE
DYes ~No DNA ONE
DYes ®No DNA D NE
0Yesg)_No DNA ONE
I I . Is there evidence of incorrect land app lication? If yes, check the appropriate box below. D Yes ~o D NA D NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metal s (Cu, Zn, etc.)
D PAN 0 PAN > 100/o or 10 lbs. D Total Phosphorus 0 Failure to In corporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): J3orz./?nult!--llf2(h:·r._j r-.c/IG~~.;;/-m ;_s ~,...,_Y:A ,HI
13 . Soil Type(s): S'OJS /;4---u~-4-/ /1Ja-E
14 . Do the receiving crops differ from those desi b'Tlated 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 pe r th e 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 app li cation equipment?
Required Records & Documents
19 . Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
0WUP O checklists 0 Design 0 Maps D Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box bel ow.
DYes
DYes
DYes
DYes
DYes
DYes
0 Yes
00ther:
0 Yes
f?Q No DNA ONE
Di_No DNA ONE
~No DNA ONE
~No DNA ONE
~No DNA ONE
~No DNA ONE
~No DNA ONE
~0 DNA ONE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Anal ys is D Waste Transfers 0 Weather Code
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain ga uge? 0 Yes [51. No 0 NA 0 N E
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes [29-No 0 NA D N E
Page 2 o/3 214/2015 Continued
'!Facility Number: ~2 -!;t:t;? loateoflnspection: ;.;::z-J::J. 17
24. Did the facility fail to calibrate waste application equipment as required by the pennit?
25 . Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes (28::No 0 NA 0 NE
DYes ~o QNA ONE
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-<:ompliance:
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?
Otber 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 nonnal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
lf yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, fTeeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the pennit orCA WMP?
33 . Did the Reviewer/Ins pector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
0 Yes jgJ. No 0 NA 0 NE
DYes ~No QNA ONE
0 Yes ~No 0 NA 0 NE
0 Yes j2g No 0 NA 0 NE
DYes ~No DNA QNE
DYes ~No QNA QNE
DYes ~No 0NA ONE
0 Yes _lW No 0 NA 0 NE
DYes ~No DNA ONE
Phone: 9/.c?-JvJ-iJl'S{
Date: j;;z. -t3-Z::?£N/
21411015
·[ll(tl:llll_lll __
Operation Review 0 Structure Evaluation
0 Follow-up 0 Referral 0 Emergency 0 Denied Access
Date of Visit: I fiiiJfl.l I Arrival Time: I //,to
~
Farm Name: ([), n1, z;ci/1:.; ;-s-
Departure Time:lj ,'.5 D I County :$~ Region: fio
Owner Email:
Owner Name: £/~ fi~ Pbone:
Mailing Address:
Physical Address:
Facility Contact: -:;.-7"~""'~=.~:....::· _:tJh--::__ __ _Aol!:::::....!:~=-=---Title: ~h~ Pbone:
Integrator: _5&z?J!I'A>fJ
Certification Number: /Z'T'T/
Onsite Representative: {'~
---~~~~-------------------------------
Certified Operator: ___ £..:;..t!~:..:..;;..=:....._ _____________________ _
Back-up Operator:
Location of Farm: Latitude:
Disch a rges and Stream Impacts
I . rs any di sc harge observed !rom any part of the operation?
Discharge orig in ated at: 0 Structure 0 Applicat ion Field
a. Was the conveyance man-made?
0 Other:
b. Did th e di sc harge reach wa ters of the State? (If yes . notify DWR)
c. What is the estimated volume that reac hed waters of the State (ga ll ons)?
Certification Number:
Longitude:
0 Yes 8-No
0 Yes 0 No
0 Ye s 0 No
d. Does the discharge bypass the waste management sys tem? (If yes, notifY DWR) DYes D No
2. Is th ere evidence of a past disc harge from a ny part of t he operation?
3. Were there any observable ad verse impacts or potential adverse imp acts to the waters
of the State other than from a di sc harge?
Page I of3
DYes &No
DYes ~N o
DNA ONE
DNA O NE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
214/2015 Continue d
f
!Facility Number: !i2-= /; q_J loate of lns~ection: 2_;;;1.--.?i-~
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes ~No D NA ONE
a. If yes, is waste level into the structural freeboard? 0 Yes DNo DNA ONE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: /Dd-[u_3 Lfol 7'"0?-?e;( 5-D (
Spillway?:
Desib'lled Freeboard (in): !?--I? !9 /'I ~ lCJ-/9
Observed Freeboard (in): :;;;-2:0 3l 3-6 33 .:Zit:_
5. Are there any immediate threats to the integrity of any of the structures observed? 0 Yes ~No DNA ONE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a 0 Yes ~No DNA ONE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes ~No 0 NA 0 NE
0 Yes L8J No D NA 0 NE
DYes ~No DNA 0 NE
0 Yes ~No D NA 0 NE
ll.ls there evidence of incorrect land application? lfyes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc .)
0 PAN D PAN > I 0% or 1 0 lbs. 0 Total Phosphorus D Failure to In corporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area
12Crop Typo(') C/YFL W.-,/z'0f&.,..> /c;,Ag /pv?Or-n/ }G;a.J-)11 ;~ Ca ;:y<$
13. Soil Type(s): po/5 /&A. 7waJ5
14. Do the receiving crops differ from those desif,'llated in the CA WMP?
15. Does the receiving crop and/or lan d 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 applicatio n?
I 8. Is there a Jack 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 comp onents of the CAWMP readily available? If yes, check
the appropriate box.
OwuP 0 Check li sts 0Design 0 Maps D Lease Agreements
DYes ~No DNA O NE
DYes ~No DNA ONE
0 Yes (;8 No DNA ONE
DYes ~No DNA ONE
DYes !;3-No DNA ONE
D Yes 0 No 0 NA 0 NE
DYes ~No DNA ONE
Oother: ________ _
2 I. Docs record keeping need improvement? If yes , check the appropriate box below. D Yes [8lNo D NA D NE
D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfe rs 0 Weather Code
D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute In spections 0 Monthly and 1" Rainfall In spections D Sludge Survey
22. Did the facility fail to in stall and maintain a rain gauge? 0 Yes ~No D NA 0 NE
23 . If se le cted, did th e fa c ility tail to in s tall and maintain rainbrcakers on irrigation equipme nt?
Page2of3
0 Yes [8.No 0 NA 0 NE
21412015 Continued
[Facility Number: 9;2 -~1.5: /Date of Inspection: 0 -;;lf: /.?
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 6?J_No DNA ONE
DYes SNo DNA ONE
D Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notifY the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow -up visit by the same agency?
DYes ~No
DYes ~No
DNA ONE
DNA ONE
DYes g)No DNA ONE
DYes i8No DNA ONE
DYes ~No DNA ONE
DYes j2g,No DNA D NE
0 Yes ~ No 0 NA 0 NE
0 Yes l3J..No 0 NA 0 NE
0 Yes 18LNo 0 NA 0 NE
c~t<L woJjl-~t;r-'~
A / j c "'F-,f;}U..) Cfd?_.-7P G-;oJ Jr11 C-~Y'-.Jw.J · (77/!?1--PS c/t7 r:, I ~ 7 _.J
/HI ht:'..ft :h-r~~ ~
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of3
Phone: '11P1!03-0 I 5 I
Date: /d-.2-f-~I/,
2/412015
Date of Visit:
Farm Name: ""J2. fY\ . J5~
Owner Name:
Mailing Address:
Denied Access
/p;J?J DepartureThn"l ,C2 J.fp I County'~ Region'
Owner Email:
Phone:
PbysicaiAddress: --------------------------------------------------------------------------------------
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 0 Application Field
a. Was the conveyance man-made?
D Other:
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c . What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
DYes ~o
0 Yes 0No
DYes 0No
d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0 No
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a disc harge?
Page 1 of3
DYes aNo
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
2/412014 Continued
!Facility Number: I Date of Inspection: u-3 -I ?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 Structure4
Identifier: lO£ LO~ ,-90 I 3{) {
Spillway?:
Designed Freeboard (in): f1 tcr l't-l:):.
Observed Freeboard (in): ~c:t ;?-{) ~ 8;2-
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 1'2J.No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
t/0 J lj_D:J-
t..2 ;9
J~ 3Y
DYes ~No DNA ONE
DYes f3No 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?
g}._Yes 0 No 0 NA 0 NE
0 Yes (2g No 0 NA 0 NE
0 Yes ~No DNA 0 NE
D Yes ~No 0 NA 0 NE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Y cs ~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 Evidence of Wind Drift 0 Application Outside of Approved Area
12 .CropType(s): .&crrud..t:L /87/-c'r-trY// CfJ ;n_ftu/e'~ / ~fo-A£
13 . Soil Type(s): ftL{:lJ /J5&J5 / WqE
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 des ign or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste appli ca tion 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 a vailable? If yes, check
the appropriate box.
DYes ~No
DYes l:Bl No
DYes ~No
DYes ~No
DYes (5g. No
DYes jZLNo
0 Yes ~No
DNA
DNA
DNA
DNA
DNA
DNA
DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
0 WUP 0Checklists 0 De sig n 0 Maps 0 Lease Agreements 00ther: _________ _
2 1. Does record ke eping need improvement? If yes , check the appropriate box below. 0 Yes 12l_No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analy si s 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey
22. Did the facility fai l to install and maintain a rain gauge? D Yes ~No 0 NA 0 NE
23. lfselected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes £a No DNA 0 NE
Page1of3 114/1014 Continued
\
••
!Facility Number: ~ -{;t{ .tJ I .• L....;.;..;:.::'-'-".....;;..;.;==::...:.__-..u....{.L....,;_____,.:~~ ... .L~ !nate of Inspection: 1;?--3~ ,i!Q;~3}-
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
DYes ~No DNA ONE
D 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 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 2 4 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes 3No DNA ONE
DYes MNo DNA ONE
DYes J).a No DNA ONE
DYes ~No DNA ONE
D Application Field 0 Lagoon/Storage Pond D Other: -------------
32 . Were any additional problems noted which cause non-compliance of the permit or CA WMP? DYes JZI No DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes ~No DNA ONE
Comments .(refer to questioJj i #):,~ijjl~nany YES answenandlor any addifiol!~l}:ec.ommendations or any oth~r C:~f!!m~~W~~•:.tt;~ti ~:.~:
Use drawings offacility to li~ti'~ft efpJhln situations (use additional pages as :necessaty). .· . -:~''/ ·.: :;, ::, _:i:.;;i{~:hf. :>
Reviewer/Inspector Name:
R ev iew er/In spector Signature :
Page 3of3
Phone : 9/p.-m-5300
Date : j7-3t;?0 0'
21412014
Denied Access
Date of VIsit: IJ'/i8b'!(l Arrival Time:l/a ~5D I Departure Time: I / ;' gJ D I County:,~ Region; r-J:.1J
Farm Name: J2 1 tYl. pdft_::; ~ /-....5': Owner Email:
Owner Name: ~V\... $&7?'3 Phone:
Mailing Address:
Physical Address: -----------------------------------------
Facility Contact: ~>£/Tji,_, Z3'4 Title: ~/?~/
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any di scharge 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 DWR)
c . What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: /7111 ~ Vp tA,.I 11.
Certification Number: /79'7 '-
Certification Number:
Longitude:
0 Yes ~0 DNA ONE
DYes 0 No DNA ONE
DYes 0No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) 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
~0 DNA ONE
~0 DNA ONE
214/2014 Continued
!Facility Number:· P: -t,&£] I Date of Inspection: /EC9!5"-/If
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: /I?) /0~ .;%;L -;)<t) {
Spillway?:
Designed Freeboard (in): I'Z:_ L.? L9-L9-
Observed Freeboard (in): 3Y._ 2:_h ;)L :J~
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 El.No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
~1> I "fO?-
L? I? --Zg¢. -···3 ·f1_·
DYes ~No DNA ONE
DYes ~No DNA O NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes IE[No DNA 0 NE
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes (2i No D NA 0 NE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~No DNA D NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > I 0% or I 0 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area
12 .Crop Type(s): ,7~J&n" /JULd,/p'd'~ ,;/,;rr/~d
13 .Soi1Type(s): A-uk I $o5 I w/()15
I
14. Do the receiving crops differ from those d esignated 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 detennination?
17 . Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP read ily available? If yes, check
the appropriate box.
0WUP Ochecklists 0 Design 0 Maps 0 Lease Agreements
DYes ~No
0 Yes Jl'l.No
0 Yes .Jl9.._No
DYes ~No
DYes (B.No
DYes (g._ No
D Yes ~No
Oother:
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
D NA ONE
DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~o 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0Stocking 0 Crop Yield 0120 Minute Inspections 0 Monthly and l" Rainfall Inspections 0 Sludge Survey
22 . Did th e facility fail to install and mainta in a rain gauge? 0 Yes ~o 0 NA 0 NE
23. If selected, did the facility fai l to install and maintain rainbreakers on irrigation equipment? 0 Yes 5il:Jo 0 NA 0 NE
Page 2 of3 21412014 Continued
I Facility Number: IDate of Inspection: //-,?0-/~ I
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes 5?1-No
0 Yes [&.No
DNA ONE
DNA ONE
D 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?
Otber 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 ~No DNA ONE
0 Yes [&No D NA 0 NE
DYes ~N o DNA ONE
DYes ~o DNA ONE
0 Yes [kiNo D NA D NE
0 Yes j2g..No DNA 0 NE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other: -----------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of3
DYes ~o
0 Yes S.No
DYes P?J..No
DNA ONE
DNA ONE
DNA ONE
'[)3-ol-5/
Phone: 9/p---q'..5__5-3300
Date: //-~/0/f
21412014
"JVS "IMJ
Operation Review 0 Structure Evaluation
Reason for Visit: 19' Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency
Departure Time: Ill : 10 A H I County: SampsO) Region: f,Q{) Date of Visit: l;ofl5'1 13 I Arrival Time: I q; IS" AH
Farm Name: D H Baft S' 1-S Owner Email: ----------------
OwnerName: Shelfe., &tls Phone:
Mailing Address:
Physical Address: --'-~!.LI,~L...L.~-u;~k'~B2-,~~....:...::~&f•~.Jr-V.L.1!1t.:L:!t~....J.,"),_7 ------------------
Facility Contact: Sh~ ~ Title: f) Wllfr Phone:
Onsite Representative: _S_h~:e.::.J~~~....:=Bq~:s..fuu...!:.-----------­
Certified Operator: Ar\"'b~ ~etft:n f.¢if
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field 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)?
Integrator: ...JHL..J...-...,;12~---------
Certification Number: ~IJ...L-~~'h!=;.._ ____ _
Certification Number:
Longitude:
DYes ~No DNA ONE
0 Yes 0 No DNA ONE
0 Yes 0No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) 0 Yes 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?
Pagel of3
0 Yes
0 Ye s
r8] No DNA O N E
~No DNA O N E
214/1011 Continued
...
!Facility Number; taO:: !nate oflospection: IBIIs=l 13
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 Structure3 Structure 4
Identifier: 101 1m ~OJ 3D)
Spillway?:
Designed Freeboard (in): ~Q,y l't) JQ,r I~S
Observed Freeboard (in): J~ ~ 3'J. ~
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
~Dl ~0-;). __,
l~.r-('Irs-
3J.. 3p.
DYes ~No DNA ONE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
D Yes 1&1 No DNA 0 NE
0 Yes l5iJ No D NA 0 NE
DYes mNo DNA ONE
DYes ~No DNA ONE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~No DNA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
D PAN D PAN> 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Type(s): Cob-fa\ J3e.AJ'1.i4...t\-ay,: £',..,fljl11~ MseeJ· ~ tvbeot
/ J J
13. Soil Type(s): Au\) B 0 B .... YYa,B
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?
Page 1 of3
DYes ~No
I8J Yes D No
DYes fig No
DNA ONE
DNA ONE
DNA ONE
DYes !KINo DNA ONE
DYes fSaNo DNA D NE
DYes
DYes
00ther:
DYes
l5iJ No
ISJ No
1K1 No
DNA ONE
DNA ONE
21412011 Continued
jFacility Number: ~d. -~'{]-I Date of Ins2ection: lD fin 0
24. Did the facility fail to calibrate waste application equipment as required by the pennit? DYes fiJ No DNA ONE
25. Is the facility out of compliance with pennit conditions related to sludge? If yes, check DYes r:iJ No DNA ONE
the appropriate box( es) below.
D Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? DYes ~No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes 0No !SaNA ONE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes ~No DNA ONE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? DYes
If yes, contact a regional Air Quality representative immediately.
~No DNA ONE
30. Did the facility fail to notifY the Regional Office of emergency situations as required by the DYes ~No DNA D~
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes fS5I No DNA ONE
0 Application Field D Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes ~No DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes f)SJNo DNA ONE
,s. ~wM:i.r wt1-rsrro;ed lh s~ is st-fll a lot-ovf--rture.. If yovc~e_
~f¥1 yOJ w\\l ha.v~ '1-o mod -tne.. tyQf-i-e_ fllh . StJil 1-eti:r 'rV~ .J otX/ ·
.'SI-d$ Slfr•ty hor ~. Jfhe_ itr-~013, PriJixJb; e/~{'l,fr_ -fh.. €x.~{)IJf tl1 Sbrli'. lf!t»11
if CCf7 oe-raterrv&'lc IS moifftl i-t> RtJ/-e~A
Rl~t \(' jOcdS~~pe,
Reviewer/Inspector Name :
Revi ewer /In specto r Signature :
Page 3 of3
Phone : 9trr li.3:ra3t»/rt6'~
Date : Oeil ~ _ ~0 13
7
11411011
...
Facility No. 'ia -IO'tL Farm Name PM Bails
Permit J COG ,/" OIC_
Date 1P h.>' ll3
NPDES (Rainbreaker PLAT Annual Cert Daily Pipe )
Calibration Date 1u~ II~ 2 3 4
Ring Size (in) lll.ch
Design Flow (qpm) ~~~~
Actual Flow lb.
DesiQn Diam.(ti) J'i()
Actual Diam. :lh3
Soil Test Date ji~I(J
pH Fields
Lime Needed Q
7 Lime Applied
Cu -I -./'Zn-1 ./
Needs S {S-1<25) ~
Needs P 0
Pull/Field Soil
lA
\B ~ J
. I .
IBnR
,q.,
lS':S: '!n ~'iO
c.b"f
-~ .en
lsS' ~rr·
IS" I l\s-_1
:~'fG ~~~
I ~In() l~fli_"{
CropYield ~
Wettable Acres .-/
WUP .../ __ _
Weekly Freeboard_......
1 in Inspections LZ
~· 120 min Insp. __ _
.erop
J. f.l ,
"/'
Weather Codes
' .
Acres PAN
J
ltno' (o_q
It L'S ~~
Verify PHONE NUMBERS and affiliations
Date last WtJP FRO ~It'll~ FRO or Farm Records
Date last WUP at farm ··l lagoon #
App. Hardware \: Top Dike
Stop Pump
Start Pump
Conversion-Cu-I 3000= 108 lb/ac; Zn~l 3000=· 2131b/ac
,
5
~ctl.
•m--15"1
~
~L
Window
J
6 7
Transfer Sheets
RAIN G~UGE
7
8
Dead box or incinerator __ _
Mortality Records
Check Lists
Storm Water
Max Rate MaxAmt
I p
v ./ II II
.7!_
• (o_
• v
Reason for Visit: 0 Other
Date of Visit: lq/cyj!.~ ] Arrival Time:ff;.:x>M Departure Time: I) FY£Atf] County: $O'"fStn, Region: Poo
Farm Name: {lc H,. GatJ ( =tJ: 1-5" Owner Email:
~ --------------------------------
Owner Name: S!tef=\o, · fu Hr Phone:
Mailing Address:
Physical Address: 1'31£ k »IJ{II! Pd.) HdjiiDII'a...
Facility Contact: SnefiQq &tl:r Title: _()=-..!.hli=ntY'~-----Phone:
onsite Representative: She.Ho, Ba:tls:-
Certified Operator: Arl?\o,, Si)eib, Baic
Integrator: -!...1\1--.!......a.B'-----------
I
Certification Number: ~I....~.J...J'lL-9!.4k=:;_ ____ _
Back-up Operator: Certification Number:
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 D Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
Longitude:
DYes {iaNo
DYes DNo
DYes DNo
DYes DNo
DYes ~No
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
2/411011 Continued
'jFacili;. Number: $'(h. [Date of Inspection: 9 ( (l.{ t{),
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. Jfyes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: Jar lO~ ~Ql 30t
Spillway?:
Designed Freeboard (in): rq.~ )~,2: ,q,) lqt r
Observed Freeboard (in): 3a :JJ'C} .~3 ~K'
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
DYes DNo DNA ONE
Structure 5 Structure 6
~Dl 'i_Od,
[qrJ lti· f'
.38" 3b_
0 Yes ~No DNA ONE
0 Yes ~No DNA ONE
vs If any of questions 4-6 were answered yes, and the situation poses an immediate public health or~vironmental threat, notify DWQ
7. Do any ofthe structures need maintenance or improvement? Yes li2! No D NA 0 NE
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required bufTers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes ~No DNA 0 NE
0 Yes ~ No D NA D NE
0 Yes I}StNo DNA 0 NE
11. Is there evidence of incorrect land application? If yes, check the appropriate bo x below. 0 Yes C8 No D NA 0 NE
0 Excess ive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN . D PAN> lO% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/S ludge into Bare Soil
0 Outside of Acceptable Crop Window \Ia/ ,Q
1
Evidcnce of Wind Drift 0 Application Outside of Approved Area
12.Crop Typo(,) !{~fZea t · "Ci!OJ"tal Bq::!;~ srnol} rh h"
13. Soil Typc(s): ___ l:e___: Sl~io, .B ,. w~ --
}
14 . Do the receiving crops differ from th ose designated in theCA WMP? D Yes I8J No DNA ONE
DNA ONE 15 . Does the re ceiving crop and/or land application s it e 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 appli catio n?
18. Is there a lack of properly operating waste applica tion equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit re adil y available?
20. Does th e facility fail to have all components of the CAWMP readily available? If yes, c heck
th e app ropriate box.
OwuP 0 Checklists 0 Design 0 Maps 0 Lease A g reements
21. Does record keeping need improvement? If yes, check t he appropriate box below.
DYes ~No
D Yes I8J No
D Yes ~N o
DYes J2S No
DYes ~No
DYes ~No
O other:
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
D Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Anal ysis 0 Waste Transfers D W eather Code
0 Rainfall 0 Stocking 0 C r op Yield 0 120 Minu te In spections 0 Monthly and I" Rainfall In spections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? D Yes l8l No D NA 0 N E
2 3 . If selected, did the faci lity fai l to ins tall and m aintain ra inbre akers on irrigation equipment?
Page2of3
0 Yes D No g) NA 0 NE
214/2 011 Continued
!Facility Number: ~~ -"-tt=. !Date of lns(!ection: Yll~ Ill.
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes C&No DNA ONE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes riSNo DNA ONE
the appropriate box(es) below.
D Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? DYes ~No DNA ONE
21. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes 0No j8NA ONE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes [S{No DNA ONE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? DYes C8No DNA ONE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes ~No DNA ONE
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes !RtNo DNA ONE
D Application Field 0 Lagoon/Storage Pond D Other:
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 ~No DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes ~No DNA ONE
'lu,~u,vu #): Explain, any YES answers and/or any additional recommendations or any other
better situations (use additional -
l~ P1eo.e yvorlt ~ btre r f~ en /tyoa.,J Go; end C/O/, D+ttfr l~_r £¥-e r11 ~~
.!J>aL shu r-e-. I Prod "C.'('{ flu n ~ r~ ip m 0"' ,~ ft'd-e Or.t1 ~vi-s ,·d '€_ h?. k j Ia-!& .-tJ, t)
~(lL
fO~vrort is ;~ ~:JDcd rAdff·
j), PitltJJ W&e ~rote/ ft;.r fbtrHtJ-P\tlltifk -b~_c )fr" ftOdVlfJI'",
~. 5fv19e eF:tnrpiicn Utlii( ao\3,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3of3
Phone: qi049J-33tr>fo<fkrJ
Date: S¢1~ ~Dia.,
2/4/1011
Facility No. tfa.~~} Farm Name OM Eqfu Date QIILf / fl
Permit / COC '-' OIC_ NPDES (Rainbreaker PLAT Annual Cert Daily Pipe)
F~ brops lO),.. ~0 ~~ 30 I t.,'(), LIO)
l'"f ::rr '
19
Lagoon Name, S for spillway 110/ 2101 3 CJ\Jl.
Design Freeboard I Last Recorded (in) I
Observed freeboard
Sludge Survey Date
SludQe Depth (ft)
Liquid Trt. Zone (ft
Ratio Sludge to Treatment Volume if> 0.45
Date out qt compliance/ POA?
Calibration Date"' 1.JJ l 1 · 2
Ring Size (in)
Design Flow (gpm)
Actual Flow
Design Diam. (ft)
Actual Diam.
Soil Test Date ~
pH Fields
Lime Needed hlo
Lime Applied
Cu-I '-"2n-l ............ ---
Needs S (S-1<25) ~l)
Needs P r:~
Waste Date <i?bt b,
-60 Day ~~dl\
+ 60 Day '·
N (lb/1000 Gal) lrbn,ml.b9
pH m.~ftJ.q;( 11~
CropYield ~
Wettable Acres 7
WUP L7"
Weekly FreeboardJ
1 in Inspections -=--
120 min lnsp
Weather Codes
~~~ 11
.r:;U;, ,,, ~ ru.I/J
4 JOJ
I
s 40 I 6 41b
6 7
Transfer Sheets
RAIN GAUGE·
7
8
Dead box or incinerator __ _
Mortality Records
Check Lists
Storm Water
Pull/Field Soil Crop Acres.. PAN Window Max Rate MaxAmt
lA-
J I L/. l
Vfl)
lJ11Y \ ~~~~~
IB lAve
I(
.J-lu~,~
v /
Verify PHONE NUMBERS and affiliations
Date last WUP FRO FRO or Farm Records
Date last WUP at farm~' · Lagoon# \.l4.0
App. Hardware d-Top Dike Sl 0 4d.~
Stop Pump 4 (p~ 4-;).6
Start Pump i.\q,) ~
1,~11: \ ~
Conversion-Cu-I 3000= 108 lb/ac; Zn-1 3000= 213 lb/ac \,1", t 1
5\-0
lnJ
~~J
lCf
\,1
I
v u
ss-.o j!"..O ~,1'
-5\lf :733 .:).,)~
s>J ~"') 3tfJ
~ --rr \r l · (,7
f.) -Jr) ~r
~Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0-Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ,, Q la.i I" I Arrival Time:lq',IQ AH I Departure Time :II\·, 36 At1 I County: s~fJD"'
Farm Name: lJH Bat+J I-S Owner Email:
~flo-Region: I I<
Owner Name: SA~ \1-o,") ra+l s· Phone:
Mailing Address:
Physical Address: -------------------------------------------------------------------------
Facility Contact: ......:;S=-n...:...::.t.....:...\1-t,...;,..,:._.....;.!B=a::....:.:fu~· ___ Title: lOe-n-t:
Onsite Representative: Sbe~ f?ail->
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Di scharges a nd St ream Impacts
I. Is any discharge observ ed fr om any part o f the operation?
Di scharge ori g inated at: D Strucmre 0 Applicati on Fie ld
a . Was th e conv eya nc e man-m ade?
D Oth er:
b. Did the di sc harg e reac h waters of the State? (If yes , notifY DW Q)
c. What is the es timated volume that reach ed wate rs o f the State (gallon s )?
Phone:
Integrator: ___JHL.....L.. --B;..L-----------
Certification Number: ..:..i7.L'f..L.~~~"'··------
Certification Number:
Longitude:
0 Yes ~N o DNA ONE
DYes 0No DNA O NE
DYes 0No DNA ONE
d . Docs the discharge bypass the waste mana gement system? (If yes, notify DWQ) DYes 0No DNA ONE
2. Is there ev idenc e of a past disc harge fr om any pa rt ofthe operat ion?
3. Were there any observab le ad ve rse imp act s or potenti a l adverse impacts to the waters
of the State other t han from a disc harge?
Page 1 of3
DYes
DYes
~N o DNA O NE
~N o DNA ONE
2/411011 Conti n ued
I Facilit)· Number: <j)J_ I Date oflnspection: fo !0. ~ /t (
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: 101 ICh -;) 01 30.1
Spillway?:
Designed Freeboard (in): ;}Q -~o -~Q ~0
Observed Freeboard (in}: 2J9 3~ 3~ 3~
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.}
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes GJ-No DNA ONE
DYes DNo DNA ONE
Structure 5 Structure 6
lfDi l/IXJ.,
-~Q :;}i)
lf8' ~7
DYes !}}No DNA ONE
DYes ~0 DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental 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
1 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
~Yes 0No DNA ONE
DYes ~No DNA ONE
DYes lRNo DNA ONE
DYes ~No DNA ONE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes fi?No 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 D 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): Coe.dal ()?.M'-'(Ia_ Ha\o·-';5/nallc1ratb o.,?r;etL · .5i;;h(t~lt{ fvhgd-
. 740 ,r 77
13. Soil Type(s): ·A-Pil}v ,Jf.e ls ; B ledlh j' j Mym.n /J '
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
OwuP 0Checklists 0 Design 0 Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes ~No
SYes D No
0 Yes [8-No
DYes ~No
DYes f)aNo
DYes (81 No
DYes ~No
Oother:
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysi s 0 Waste Transfers D Weather Code
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Page 1 of3
DYes ~No DNA ONE
DYes 0 No {R'NA 0 NE
21411011 Continued
IFadfity Number: ~ -G'fr loate oflnspection: ll) lag/ IJ
24. Did the facility fail to calibrate waste application equipment as required by the perm it?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Ye s [5(tNo 0 NA 0 NE
D Yes 5a'No 0 NA 0 NE
D Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond D Other:
D Yes 18J No 0 NA 0 NE
DYes 0 No QkNA D NE
D Yes ~No 0 NA D NE
0 Ye s 18jNo 0 NA D NE
DYes ~No DNA ONE
DYes ~o 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?
0 Yes (2No DNA ONE
DYes gNo DNA ONE
0 Yes IBfNo 0 NA 0 NE
, S?tflbe warlc 0" btte.. Sfak ~ d.lllJorns J. 1oo bad._ , Pi-4-eftnl,hotif'/.'t}
3r0J~o-,...w~vtsrd~:d f'r,rrde. ~ lof-es, &xrJJ'obmo~>lfy en "'"of-IJPl" ~dM.
Is, Bad lnferla~1rn of-( ~,ffd_ Jfl s~ bt'Ols. P{{:d &Cf/.1 sa lcl ~e. Sf~"Dfttl. siJn.,-e;
+his yerr, HaJ~eldr )~ok 3ooi. Fi-fldsj,q-e lt~J.. ffl Sf I~ '0010.
,SI~es"'"~ J.01e "'' 3010 • lv•il be ~fr~ -(/y ~f',(Hi(w ~e-&,J o-f.yeor.
~~lot of sf'r;-tleld_s t H{))i Wfff_ ()'\r ~/,Pl())(e_ tri~-vire Jveio d'o'Jfrl,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of3
Phone: Cf[Q:LI.J3:33a? (office}
Date : De+ d; riO/[
214!101I
' . ~ ...
Facility No. SJ-{QI/r Fann Name .IJ=..:.....M-=--1 ~B=a"""'BIJ-r ____ Date jolirdll
Permit / COC J OJC_ NPDES (Rain breaker
10 ~ ~ , 01 ~ j OJ 301 I ~~'
Pop. Design Current FB~~It 1 ~ .:\j )~),, "'(
1-11 .I Type Drops 1v 1:1.. l.al.. Jl lfnf;h.j~ .11.'
..... ~ .... 't /;;ritt ~, ,.,.,. R,;.!l, rn "JI 1 I "'i\}j/{JJ II
I~ .JJ~.
. '
\ill J02 -;:)..0/ 3ot ]i l/<'Jl Yol.
Lagoon 1 2 3 4 5 6 7
Spillway
Design freeboard
Observed freeboard inl . "A· 3't 3J. ~ y~ 1./ i~· Sludge Survey Date ~ I
Sludge Depth (ft)
Liquid Trt. Zone (ft
Ratio Sludge to Treatment Volume I
et7f'J:PtU -&utJ~ . r!»Pt.Jf)
Calibration Date 1311111 2 .31~11 J 3 3/3111 4 Qli4ltJ 5 6 7 8
Desiqn Flow l5) I~ )tr 5J' 7 15)--
Actual Flow I o;-I I~ 1/).J 1'S) tJ/
Design Width Ci'-16 ~~{) bl!O 'd'i!J I~
Actual Width ~~ -;).{i)() ~ ::)~ l~..d/
'tft ,lh ,q) rt) "" I
RAIN GAUGE Soli Test Date q ld.oltt
pH Fields
Lime Needed Uo .
Dead box or incinerator __ _
Lime Applied ~OCQ ~¥riY,.
Cu-I ~ Zn-1 ____:::::__ ~ ..1 v
Needs P JJp
Cro Yield ...;_./
PuiUField Soil Crop Acres PAN
tA AvR ICi3Ho.l~£ H /(;,) 1;)7; fro{-~0
\~*thull;)~ . I Y.l ;)-;+; , vn J~/7 l:n ~-
. /{\ t.j l\lr -3Ll 'JIY 1\Y v\~ ""' Ro~/lvln.+ :)'6..) I\~ · f:n
~~ BoR l3J.~ ll£b ~-[!
~~~ ·'iwrr, ~~~8 Iii~ r~ J
,.
. ~oJ~c
Verify PHONE NUMBERS and affiliations
D~e last WUP FRO Date last WUP at farm
cJ.-\LI-01.. ~-e_
FRO or Farm Records
Lagoon#
Top Dike
Stop Pump
Start Pump
'
Conversion-Cu-I 3000= 1081b/ac; Zn-1 3000= 213 lb/ac
Mortality Records
Window Max Rate .Max Amt
M«-A..-,; /qhJ ~-M J14r ,{· i
J I
l
l
~hl1~'!1i~ '\.1/
\ ~ y • .l)
·-¥ ~i-·J/
SGo.·i~ LJ/;
App. Hardware
lilllb 5G , -~ .... 1-\--i..r-..J,...;J'/'fcL :G".,->pi=-AF -1.{1 '.') • H<./ j VI • '
M~~-i'~l~-c ~~~
\~1{;'.''1:t~I~
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 0 Denied Access
Date of Visit: 1\a \a litO I Arrival Time: L..:...L....U..C~,:....:...J_, Departure Time: Pl~ l{j 'P-11 County: ,So,t2fOJ '
Region: F .eo
FarmName: D H BaH< 1-5 .. Owner Email:--------------
Owner Name: Shelj...o, Phone:
Mailing Address: ----------------------------------------
Physical Address:----------------------------------------
Facility Contact: -=S:;;....,\.~..,;e:;....\.....:.k::.:.....L.._...a.?qfr=-=-.~...oS.:.... ___ Title: _,(J;;,.L..L:W!'-'-n.....,tr:"'-------Phone No: d~q-3~~ (h()ne )
l _ o . 1 \ u ...... 0 ~~~f)ffer)._ ?
Onsite Representative: She\-un uQrr5 Integrator: ....aU-4--D.L.L-------------
Certified Operator: Arrfil&JT S' l?a+\-5 Operator Certification Number: fJ9'%
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? 0 Yes lSI No DNA ONE
Discharge originated at: D Structure 0 Application Field 0 Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (lfyes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters ofthe State
other than from a discharge?
Page I of 3
DYes 0No DNA ONE
DYes 0No DNA E:INE
DYes 0No DNA ONE
DYes &!No DNA ONE
DYes gNo DNA ONE
11/18/04 Continued
Date oflnspection I rah I I 0 1
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: )OJ 10~ @0)
j :301
Spillway?:
Designed Freeboard (in): d.Q clo ~Q OlD
Observed Freeboard (in): 2~ ~1:::: 3J t;)'X
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/largc 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 ~0 DNA ONE
DYes 0No DNA ONE
Structure 5 Structure6
40[ L/Od..
~ :JfJ
3:?.
'
:?8
DYes ~No DNA ONE
DYes 6lNo 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 ofthe 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?
8lYes 0No DNA ONE
DYes '-;BNo DNA ONE
DYes YNo DNA ONE
DYes f8"No DNA ONE
11. Is there evidence of incorrect application? lfyes, check the appropriate box below. DYes ~No DNA D NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area
:: ~:~p~:::) ~t 1 k;A1~vt!ns:'~·~:J;,5nlhf'lh~ fvht>it
14. Do the receiving crops differ from those designated in theCA WMP? DYes 8 No 0 NA D NE
15. Does the receiving crop and/or land application site need improvement? DYes ~No 0 NA 0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre deterrnination?O Yes C3-No 0 NA 0 NE
17. Does the facility lack adequate acreage for land application? D Yes };9 No 0 NA D NE
18. Is there a lack of properly operating waste application equipment? 0 Yes E No 0 NA 0 NE
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Pagel of 3 11128104 Continued
-I F~~ility Number:~ -Gtt I Date of Inspection I ()ec '3'pxPI
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
DYes ~o DNA ONE
DYes f:iNo 0 NA 0 NE
21. Does record keeping need improvement? lfyes, check the appropriate box below. DYes ~No DNA 0 NE
0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers D Annual Certification
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
lfycs, 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?
(, 'fkbe_~lYltD-) a.fev bo--esfot_j Oil sl~~ ~ lf_Jwn t.fOI
, ~ o dron --tt l-es
GK>Q:L re l crd .s.
Page3 of 3
DYes 18No DNA ONE
DYes 0No 9NA ONE
DYes EINo DNA ONE
DYes IS!No DNA ONE
DYes ~No DNA ONE
DYes 0No ~A ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes lS"No DNA ONE
DYes 'KINo DNA ONE
DYes 3No DNA ONE
DYes ~No DNA ONE
12128/04
-FaciTity No.'5d:04I
Permit /coc
Farm Name 0 /1 lqgtH Date Ia ( ~ { I p
NPDES (Rain breaker o1c_/ ... ---Annual Cert ) PLAT
Pop. Design Current
T e
Lagoon
Spillway
Design freeboard
Observed freeboard (in)
Sludge Survey Date
Sludge Depth (ft}
LiQuid Trt. Zone {ft
Ratio Sludge to Treatment Volume
Waste Analysis Date 10/ fQ I 1 f)
-60 Day ~ rfq'f(D
+ 60 Day
N Amt {lb/1 000 Gal)
pH
'J ) '
Pull/Field Soil Crop
lA A ... ~ oc~-~a 1 :Y...,bl
I~ /l )f I
vn~ fJ i1.l B
1Ut14 1-vB ',V
l.B AuB 5o1 /'.vh-mt-
l.JJI d.. ~~oJ3 I'
S'll w-a, ._y
Verify PHONE NUMBERS and affiliations
I I I I
1 2 3 4 5 6 7
JQ_L -::JO I :301 lf fj I t../'lrl
4~/'(0 -,•
:~. <iY 3RI ! ;:)., 0 ~,y ".!:t-71
~rl ILl I
6 7 8
RAIN GAUGE Wettable Acres ---::.---
WUP Dead box or incinerator __ _
Weekly Freeboard .....---
1 in Inspections .......-
120 min Insp. __ _
Mortality Records
Weather Codes /
Transfer Sheets oof 5 /5 -g I q
• ;!?(ft/({)
, I I
Acres PAN Window Max Rate
lb,3
Ll, I J
J'SrCf
"3/,~
~& ._) IXJ /C/J
3~ (j II V 1J (Jr"l)
LJX,K II~ 1.{()
MaxAmt
1
Date last WUP FRO Date last WUP at farm
FRO or Farm Records
Lagoon#
Top Dike
Stop Pump
Start Pump
Conversion-Cu-I 3000= 108 lb/ac; Zn-1 3000= 213 Jb/ac
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 0 Denied Access
DateofVisit: llO!d/0"( I ArrivaiTimed IJ;OQ Pn J Departure Time: l t~JO PtJ I County: So,(Sfb Region: f'R()
Farm Name: Di Hr Bqjf_s 1-5""' Owner Email: -------------
Owner Name: She \{o., & H:s Phone:
Mailing Address: 1~5" Vvo.l cro5J Rd._ ---LH....r..Joioll..l'-jtf'O..uoO~I.L....ll dw~------
Physical Address:----------------------------------------
Facility Contact: --"S=-:....Lb...,.-e,'"'-l~--=-+-& .... fu~------Title: tJwn.Pr Phone No: ;;)8 Y -fhd.J
Onsite Representative: .... S:;....h......,e ...... l ...... k--r, __._P,...,.a...,tt .... cr.:;..._________ Integrator: H.vrpo/ -Brown
Certified Operator: Axh 0\V S (3$ Operator Certification Number: A tvA 099~
I
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
l. Is any discharge observed from any part of the operation? DYes RNo DNA ONE
Discharge originated at: D Structure 0 Application Field D Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (Ifyes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does 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 0No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes jgf No DNA ONE
DYes !)(No DNA ONE
1'1128104 Continued
·.
I Facility Number: ~d.-0lfLI Date oflnspection 11 ol ~ lo? I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: li1t 10~ ~01 3()1
Spillway?:
Designed Freeboard (in): ~0 ~0 'Qo
Observed Freeboard (in): ~~ 3y--~~ "'
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
dO
3;)
I
DYes t:i4'No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
LfD! . l.fQ;;t_
O>D CJO
.Jd 3~
( '
DYes ~0 DNA ONE
DYes !Sl-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? 0 Yes ~No 0 NA D NE
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management 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?
0 Yes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
II. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes ~No DNA D NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
12. Croptype(s) C¢rlalk,.,vJa tlo..v ~Small Gta!b O.S c So.,.bean. Nh.Ptff-r7 ...,1 >
13. Soil type(s) Au B Is_; BoB S" ; iVa B Is
14. Do the receiving crops differ from those designated in theCA WMP? DYes ~No DNA ONE
15. Does the receiving crop and/or land application site need improvement? ~Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment'?
Reviewer/Jnspector Name
Reviewer/lnspector Signature:
DYes
DYes
0No DNA ONE
~NoD NA 0 NE
l:ihJo DNA D NE
~0 DNA ONE
'•
I Facility Number:~ -t,Cj~j Date of Inspection If 0 lri/0 9 I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box. D WUP 0 Checklists 0 Design 0 Maps 0 Other
DYes ~No DNA ONE
0 Yes l:iNo 0 NA 0 NE
21. Does record keeping need improvement? Ifyes, check the appropriate box below. DYes ~o 0 NA 0 NE
0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis D Waste Transfers 0 Annual Certification
0 Rainfall D Stocking D Crop Yield 0 120 Minute Inspections D Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes l'JNo DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes tjtNo ~A ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0Yes.·0No DNA SNE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes 0No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes c,ilNo 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 18'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 lSI No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fai I to notify the regional office of emergency situations as required by DYes EI"No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Revi ewer/Inspector fail to discuss review/inspection with an on-site representative? DYes 8No DNA ONE
33. Does fa cility require a follow-up visit by same agency? DYes ~No DNA ONE
' • ,.,, ' t-. r ,._ ~ ~ • r., ' • r ' -, 0
. .
11128104
·.
Facility No.~m'
Permit / COC
Pop. Type Design
Farm Name
Current
~Jif Btrii-J r-s-
{) l f/Ta 11 I rD'tf :J t J f~rme_ -Date _____ _
OIC_ NPDES (Rain breaker PLAT Annual Cert )
FB Drops
I I I I
..... :mr -~ "'71"1~
I~ d-f '-H ~J.... sta-i:-,;). h I L .4-o I}.. ~ ~ 3-{ l.fOJ lfo.
Lagoon ,.. 1 2 1\ 3 I 4 5 6 7 ~Nit/It -:r rq;
Spillway ' 3}-tn :~-10 \ I J/-IJ(/. 3-/-. c .. n Jf-Th '3<1-<(tf -stor
Desiqn freeboard _\/
Observed freeboard in " Sludge Survey Date I \ Lj.:J.
SludQe Depth ttf & % ";((b .JS I \
Liquid Trt. Zone (ft) J
1--4-,(JJ/ \~ISR' M Jf(X '-IQ I· 'NO~
Calibration Date 17 l!nldf 2 3 4
Desiqn Flow ~~~ l5T"" ~m-i.'>-1
Actual Flow 00 /)/. 1'-19 /)
Desiq n Width 1~4() 'J"/(J ~~..~a ;.)4,()
Actual Width lr:h"f 1:::>"'1 d~l ;:J(u{)
Soil Test Date sf;::))/0?
pH Fields
Lime Needed Cbtfiflll.o5H-ef-Ot_
Lime Applied
Wettable Acres--~
WUP c..-/"
Weekly Freeboard v
Rainfall >1" \,.<"""
Cu ~ Zn .._...,.-
Needs P--· c;-
C ro p Yield /
Waste Analysis Date l~l.~c\fb
-60 Day
+ 60 Day
N Amt (lb/1 000 Gal) ~ .. ~.J.l :-u.
9*---~8~. i;) "1
J /
1 in Inspections __
120 min Inspections
liN~\~ rm~J.. _/h lllrt ... ., .
bl .:>.~~3 ~
b.~.l~ d--> ~
/ /
\ l:.c;t>('l
!J' ..b.
s·
1~)'
'~-" ~lJj')
-;J_fJ_
~
.Jd--3d..
'Rfilt::r-~ If ro /OJ ~
6 7 I 8
..
Weather Codes
Transfer Sheets n Ia
RAIN GAUGE
Dead bo x or incinerato r __ _
Mortality Records
..
Pull/Field Soil Crop RYE PAN ~cr-WindowJJ4 Max Rate MaxAmt
lA 1,4.& GataH~>r& ~ 1100 :.a.d J'LJ ~---(}.fa If) i'-J I fl' f) "1.
fr., Aif) I l:n-r . . " I ,
I
IIH\'l.., A,;p, :h"r' .. \Y
I \J11 u ~~ \,J..-JTtJ \V Htr ... _Av_d_ \..V
iJ ~£ Sov--:--MQrl ,. 1;)0'/~ /1 -P--sf.&Sr.vl-lttl o. <P
·~p, lJ!'I ~ ~~ loo/;A 1 vl "
Snr . wn.B \...),. liA/~/ ~1
rno
*
loo~Sf'lt 15"-tc:t
... so.: feb-11~
Venfy PH O NE NUMBERS and aff1hat1ons P-0n()..f A... ~1 1
Date la st WUP FRO ~('f-0) V'ft.. 3-Jj-@ate last WUP at farm -/' ·~· ' I
FRO or Farm Record s ~
Lagoon#
Top Dike 411 mP'~l rft Jo ~ Cf~)(A:}rftrrJJ ~Oca-
Stop Pump
Start Pump
Conver sion-Cu-I 3000 = 108 lb/ac; Zn-1 300 0= 2 13 lb /ac
LP/1 ....,.
y 07r-·a, b ¥
th t;.'h.r.-tf tJ.. f/1 f -P{t 1-P-
Type of Visit 'S Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Q Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Region: fllO Date of Visit: [b,lt 1m I Arrival Time: hS>; lYPO I Departure Time: l;;)",clr.PI11 County: Sllt4fJ"l
Farm Name: .b H Batf:f #-1-:£ Owner Email: ------------
Owner Name: .....lS~h~f..u\tth~------_....,B .... af±""'"'"""..._( _____ _ Phone:
Mailing Address: Ji5" W'?CIQ.U /I.J.
Physical Address: __ .....-
<::"\.. \.1 . nn:i(---r ..1 1 ,_ 1 ) Facility Contact: cJIJ £;rrA. Q.L.!J:_ Title: ...lio~~,;..:~..:..tft:._________ Phone No: :18 -,-~~a.. tS
Onsite Representative: . ._$'..._h .... e.=-o..~-'"='-..__Ba_fu ........ '----------Integrator: _.._M-......._ .... 8'--------------
Certilied Operator: .flrrtttfi!J r. ----.:&::...__ftr...;.o..c:_______ Operator Certification Number: At-~A-IJqq~
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm:
C urrent
Discharges & Stream Impacts
Latitude: D OD'D"
• Design··.· Current
Wet Poultry CapacitY 'Population
. . . ! •, ~·
Dry Poultry ·:,· ·•.'·:·····:.·· ..
0 Layers
D Non-LllY.ers
D Pullets
D Turkeys
D Turkey Poults
D Other ..
Longitude:
1. Is any discharge observed from any part of the operation? 0 Yes 51No DNA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other
a . Was the conveyance man-made?
b. Did the di sc harge 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 sys tem ? (If yes, notify DWQ(
2. rs there evidence of a past discharge from any part of the operation? , ·· . . ___ /
3. Were there an y adve rse impacts or potentia l ad verse impacts to the Waters of the State
ot her than from a discha rge?
Page 1 of 3
DYes 0No DNA ONE
DYes 0No DNA ONE
OY ~s 0No DNA ONE
DYes .8No DNA ONE
DYes Q.No DNA ONE
11/18/04 Continued
A Facili~ Number: $ a..-G 'fY I Date oflnspection Kol! /Oj I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? DYes RJNo DNA ONE
a. If yes , is waste level into the structural freeboard? DYes 0No DNA ONE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: IOJ IO~ ~OJ ~t)J • '-lo 1 w~
Spillwa~:
Designed Freeboard (in): ~ ~a.Q }e(a~ J.'(d.V !:1::~ #;)f) c Fbj~cn
Observed Freeboard (in): 3Y 33 ~~ 0>9 3l/ 4:>.,
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes ~0 DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public bealtb or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8 . Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
0 Yes 18JNo DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
0 ;ves jgNo DNA 0 NE
II. Is there evidence of incorrect application? Ifyes, check the appropriate box below. 0 Yes DaNo DNA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN > 10% or 10 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s) c~ S«.,.,J~I!I:fj-SG OJ; s <Jkms J.-11& i-
13 . Soil type(s) A'!._ __ _:_ BoD~: _ 8 \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?
0 Yes I&JNo
DYes ~No
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?O Yes IS No
17. Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
Reviewe r/Inspector Name
Reviewer/Inspector Signature:
Pagel of 3
DYes ~No
DYes ~No
Date:
11128/04
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
Continued
Date of Inspection ~~~ li k)i'
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? lfyes, check
the appropirate box. 0 WUP 0 Checklists 0 Design D Maps D Other
DYes ~N o DNA ONE
0 Ye s 18 No 0 NA 0 NE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes 1M! No D NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
7. \)lellc.. r)[o...-ora,ttL t ~Of:>.. ~ '9'
Js, L i ~ ~ "'" r a f f llrtl_ + h u-s vn,ne r
DYes S No DNA
DYes 0No (ENA
DYes ~No DNA
DYes ~No DNA
DYes ~No DNA
DYes 0No rslNA
DYes [)jNo DNA
DYes !RNo DNA
DYes 181No DNA
DYes ~No DNA
DYes ~No DNA
DYes ~No DNA
I~, lti<lf-f I c itel hea,r. A.bt>J}. -It, slv+flll>~ tv heat-,
~. Se,J ~ <300"1 ts I "rife J vtver -w ~ lt'j~ -fbr ~ Otr :14e ~f">rf# 0 I') ~;)(Jot? I
Page3 of 3 12/28104
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
O N E
.. FacilitY No. %}-G,'ff: Farm Name ~f1 fXlttf f-'} Date)(}( f lot
Permit COC OIC_ NPDES (Rain breaker
Desi n Current I FB Drops
I I I
.Jru. 301
Lagoon 1 2 '5 4
S_pillway
Design freeboard
Observed freeboard in .)1 .Jt..f 4/ ';:l., 't
Sludge Survey Date -~ fq ltn I
Sludge Depth ft) & % , 'i'r 3.8"~ l:>.cn ~.~
Liquid Trt. Zone (ft) ;.o~ l'l,'f.J 1\t.J" o.f,cl}
A ffljtl)4 ~IcY ~fffw\
"""
/}
Calibration Date 1<l't.nlm ~ <& t\O_IJ): 3 4 5
Design Flow ~~
Actual Flow ,
Design Width ;;)~ rO
Actual Width ;,:,q
Soil Test Date 1 holoS'
pH Fields
., ·~S
I~
;)'to
~~
Lime Needed 8-1.(,. l'/Ac-
Lime Applied l)4w:li ins~
Cu .,..,.. Zn ../ ~
Needs P--a-J"Ttio.:.i~
Waste Analysis Date ,blfit
-60 Day
+ 60 Day
In-ISJ
~~~ \Sd.
~ l~'fl)
:It, I l;)lri..
Crop Yield ._/
Wettable Acres .c
WUP ;)03 v
Weekly Freeboard ..../
Rainfall > 1" ~
1\.SY
llQ
~~~
O>b3
N Amt (lb/1 ooo GaO 0.1.l.~~~..5' ~" ~s pH 7,"3-..,, ct J ./
Pull/Field Soil Crop RYE PAN Window
lA-
\8 I
Ut\"\
100 /(A
~"" .J . .JnJ
-~-\41ni
Sl1o\ot
Verify PHONE NUMBERS and affiliations
PLAT Annual Cert)
I I
~Ol ltih
5 6 7
•0 1 \J~
' j,q, 3,75
'5()") ~, lq
6 7
1 in Inspections
120 min Inspections
Weather Codes ·
Transfer Sheets
RAIN GAUGE
Max Rate
I
+-
8
Max Amt
I v
Date last WUP FRO Date last WUP at farm
~len_
App. Hardware
. "'' ~r Farm Records
Lagoon # 1-I ~ · I· ~ ~
Top Dike ;)L 0 ~0 ~Lo
Stop Pump q h.t•'0 ~~.i-:10 'n'\~
Start Pump yqJ -:ao &b'·~'lO ~q.~ ~~o
lr \•I ~~· t-l. 3 'i-1
)0 ~ i \ ~0 ~ • ;)0
.,_,, :Jrt," +~" -t·-.1''''
~~a';ility Number~~ )-_HJ!'BJl .. Division of Water Quality (Qt~~vl•l 0 Division of Soil and Water Conser\'ation
0 Other Agency
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 OOther D Denied Access
I J I Departure Time: I n lS: I County: ..S~I'\. F~ Date of Visit: ~6j,7J. Arrival Time: l q 30 Region:
Farm Name: nm. ~44~ it l-~ Owner Email:
Phone:
!\failing Address: -----------------------------------____ _
Physical Address:=-----..,,....---.....,.....-..,...-,------------------------------
Facility contact: -~=..;...~t-..... 1'-~:..;;:-"""'n......__,&>_........:..._t.._J...l.J~...__...,......_Title: _...:::oO"'-law~au..Doc:·~---PhoneNo: ____________ _
onsite Representative: ~Hen &. +h I m-ntegrator: -----..:::ooo:..-----:-:=?"r:;;oor._..--
Certified Operator: ~ €.. (~I'\ &A+{~ Operator Certification Number: ---"'---L--
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D " Longitude: D OD'D"
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
I I
1 ~.:::18:::.. .:..:~..;;;:::.:.,.~r=La::.~:Y..::.:cr:.__..~...-__ __._I __ ----JI
ID Wean to Finish
0 Wean to Feeder
!iiFeeder to Finish J~(rj) /'/"!J'tO
ODairyCow I
i
0 DairY_ Calf
0 Dairy Heife1
0 Farrow to Wean
0 Farrow to Feeder
D Farrow to Finish
0Gilts
0Boars ...
OD1y_Cow I
I 0 Non-Dairy I
0 Beef Stocke1 I
I
0 Beef Feeder I
0 Beef Brood Co~ I -. ----
Dry Poultry
0 Layers
D Non-Layers
0 Pullets
0 Turkeys
Other 0 Turkey Poults
Oothcr IDother I Number of Structures: ~
Discharges & Stream Impacts
1. Is any discharge observed from any part of th e operation? 0 Yes J\:tNo DNA ONE
Discharge origi nated 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~A ONE
c. What is the estimated volume that reached waters of th e State (ga!Jons)? -I
d . Does discharge bypass the wa ste management system '! (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
DYes D Na-fij:NA ONE
0Ycs ,...fr.No DNA ONE
DYes 0No~A ONE
12128/04 Continued
I Facility Numbe~L -QKj Date of Inspection
Waste 'Collection & Treatment
4. Js storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
[oc{re 1 Structure 2 Structure 3 Structure 4
Identifier: /02 Zol ~0
Spillway?:
Designed Freeboard (in): Lo Zo zc) ~~ Observed Freeboard (in): cJ.J J..tj_ ~J/
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees , severe ero sion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes MNo DNA ONE
DYes (i'No DNA ONE
(
Structure 5 s~0ez_ l/Ol
~ zo
io
DYes ~No DNA ONE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7 . Do any of the structures need maintenance or improvement?
8. Do any ofthc stuctures la ck adequate markers as req uired by lhe 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/improvemen t?
DYes ~No DNA ONE
0 Ye s fii(J No 0 NA 0 NE
DYes ~No DNA ONE
DYes ·~o DNA ONE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes lji(No DNA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs 0 Total Phosphorus D Fai lure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptabl e Cro p Window 0 Evidence of Wind Drift 0 Application Outside of Area
12 . Crop type(s) ~fu~m~wJ~R:.............:~~,.-Sm~~G'!::"'L-.... ~o'~-/""-s ~~~· =\------=....:~:.....;..=~1:-"---. -------
13. Soil typc(s) ~ 4.. 6} Ba ~ I (A)alJ r I
14 . Do the receivin g crops differ from those designated in theCA WMP? 0 Yes '6a:No 0 NA 0 NE
15 . Does the receiving crop and/or land application s ite need improvement? 0 Yes ~o 0 NA D NE
16. Did the f acility fail to secure and/or operate per the irrigation design or wettable acre determination?O Yes ~No DNA 0 NE
17 . Does the facility la ck adequate acreage for land application?
1 8. Is there a lack of prop erly operating waste applicat ion equipment?
DYes ~o DNA ONE
DYes ~o DNA ONE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name
Reviewer/! nspector Signature:
j Facility Number:~ J... ~~ I J
-'-Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box. D WUP D Checklists 0 Design D Maps 0 Other
DYes bQ'No DNA ONE
DYes il,No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes r}J No DNA D NE
D Waste Application D WeekJy Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Annual Certification
0 Rainfall D Stocking D Crop Yield D 120 Minute Inspections D 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 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 ofthe 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?
Additional Comm~~ls.f~~i!for Drawings:
~11-f·,n~e. .fu ~ 0}") ~~ ~ co~
bo.M~.
Page3 of3
DYes ~No DNA ONE
DYes 0No ~NA ONE
DYes a(No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes 0No !)INA ONE
DYes ~No DNA ONE
DYes 3bNo DNA ONE
DYes ;a No DNA ONE
DYes fJNo DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
.-bti~/i:.:·~~~·::¢.~~~~~~~
....
~ f-
11118104
.. . ,,
Facility No. ~ ~-&c.f{ T ime In 'f 30
.. Farm Name 0 m ~1ts ~ { -s-
Owner ~~ &Jb
Time Out---......-=-Date Jz/ 2-0/01
Integrator YY"\ -8__ •
Site Rep . :s:a:JJ<.;.;;
Operator-----------------No.--------
Back-up ,.. No.--------
COC z Circle : ~ or NPDES
Design Current Design Current
Wean-Feed Farrow-Feed
Wean -Finish Farrow-Finish
c Feed-Finish""} I'X~ (DU Gilts I Boars
"CII IUW vvean Others
ARD: Design . J . fi---r -ilo ~-1 Observed I I I J ..
Calibration/GPM /,<;"o-(\'2----'------
FREEBO
Sludge Survey i / Q. ( ( o {c. ""
crop Yield 1/ w • Waste Transfers ____ _
Rain Breaker __ _ RainGauge ?
Soil Test V:: Wettable Acres--~--. PLAT • ;;::>
Weekly Freeboard-~--~ Daily Rainfall __ _ 1-in Inspections ____ _
Spray/Freeboard Drop ----------------------
Weather Codes __ _ 120 min Inspections __ _
Waste Analysis:
Date Nitrogen (N) Date Nitrogen (N)
Pull/Field Soil Crop Pan Window
"' 1'1 /) I ..,.... /'
llu f) rlLvM H oL t\ {VIa v _u..v-..-y
r-. I I
~ &,, 0/5 r::oJt:; l'J q II'-JtY~ 1 I r:.,~, .... J ""r
I {J -I I
l " 1-
AvlS Sav,. I'LO ,~ ~
6-J!LQ_o-.--f qA, ~h /) --Q.LW ·r Q
n l )'n~ I ()U
[» I) ) ( 1 f... _g{)._A; 1/l '1
• I
I \ _fJ_ ('\
IJJa. .n ~0~ 1/L
0 lAJ~-f ~· Ul
·-···----·---···--------------------------
;;:; '1 :;. () --f '----.. ~cj) t:'
-J --........ 0 <:>
lt-D o 0 -1_g' Z' 0 _l _d-.
;). o ~ D
~ If~ o 0 ---. 0 ~ -{;' -
--~ ~ -. . N --1) _J
i];, \f)~ s --
--...c: w
0
-J -
_..........._ ~-<:;.
Q_
0
(' -... -t {'
(J
Type of Visit • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit cf) Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 other 0 Denied Access
Date of Visit: I rt\ 1.$.)\ iM Arrival Time: 19 2tS I Departure Time: I l I /S I County: _....:!....,;~===~
Farm Name: 0 {!) \ t:>o .. :·\·h --tt.. l -5 Owner Email: -----------
Region:~
Owner Name: ~~\too _'\&...-..-.=..*..!..·....:::....~..___ ___ _ Phone:
Mailing Address: -----------------------------------------
Physical Address:----------::::----------------------------------
Facility Contact: ~.Q . ..\ *on ~4:\.s Title: _<0_,._"-u..:>"""""":....arRX~:;..o_----Phone No:._,. _______ _
Onsite Representative: -=~====.==•:!...~.!...3o..."-l_4D-l..l0~V\...~....-_'Bn...;:=:;,+.:..._f.-:--=S.==----::---Integrator: (X) l ~ ~Y\..
Certified Operator: ShfJ-!-oh :e:x;;;t;f_s Operator Certification :::0 1 :J9q::1
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? DYes ~No DNA ONE
Discharge originated at: 0 Structure D Application Fie ld 0 Other
a. Was the conveyance man-made? DYes 0No pi(NA ONE
b. Did the discharge reac h waters of the State? (If yes , notify DWQ) DYes 0No ~A ONE
c. What is the estimated volume that reached waters ofthe State (gallons)? ----d. Does di sc harge bypass the waste management system? (If yes, notify DWQ) DYes 0No~A ONE
2. Is there evidence of a past discharge from any part of the operation?
3. We re there any adverse impacts or potential adverse im pact s to th e Waters of the State
other than from a discharge?
Page I of3
DYes Jlb'lo DNA ONE
DYes Wo DNA ONE
12/28104 Continued
I Facility ~umber:~ 1:-(Jj$'1 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 1
Identifier: L f 0 I
Spillway?:
Structure2
lloc_
Structure 3
LdO (
Structure 4
L 3co I
DYes ~No DNA ONE
DYes 0No ~NA ONE
Structure 5
LfOI
Structure 6
t+oy
Designed Freeboard (in): ----:J~Q:;...._ ____ ;J_r.-.._,()=r-----~a2~0=:....-__ --=t:l~O----~-=---
Observed Freeboard (in): --.::3J.::::oA..J,__ ____ _,djp::;.;=:..;... ____ __...'j ..... b:-____ ...,.J])_'-----::........c;..._-
;),0 ~ 3:& ;jJ-
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes ~0
DYes lfbNo
DNA ONE
DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes jHNo DNA ONE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. D Yes ~o D NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area
12. Croptyp<f'l &x-mu:-~ <W"Q~ ;
13. Soil type(s) A u..~ __:_ ~r \..(h _
14. Do the receiving crops differ from those designated in theCA WMP? DYes ENo 0 NA 0 NE
15. Does the receiving crop and/or land application site need improvement? DYes ~No 0 NA 0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes )g! No 0 N~ 0 NE
17. Does the facility lack adequate acreage for land application? DYes ~o 0 NA 0 NE
18. Is there a lack of properly operating waste application equipment? DYes &o 0 NA D NE
·c~lnments"'(f~fer to question#): EjpJain any YES answers and/or r:(!(:o1JJ)1l.ell.t:latiorls or any other \;Uilllu.,o~~~·.~
Use drawings\of facility to better explain situations. (use additionallJ'<~;~;o:;,.,<U ne.=es~sar
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Pagel of3
i F~cilify Number!)~ =<lJf51 Date of Inspection 0 ~ zq ()~
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 0 Maps D Other
DYes ~o DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~N o DNA 0 NE
0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysi s 0 Waste Transfers 0 Annual Certification
0 Rainfall D Stocking 0 Crop Yield D 120 Minute In spections 0 Monthly and 1" Rain Inspections D Weather Code
22 . Did the facility fail to install and maintain a rain gauge?
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24 . Did the facility fail to calibrate waste app li cation equipment as required by the permit ?
25. Did the facility fail to conduct a sludge surv ey 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 as sessment (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 documen t
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or ai r quality concern?
If yes, contact a regional Air Quality representative immediately
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?
Additio.nal CommentS ~·~'ai~r Drawings: ··.'
Page3 of3
DYes ~No DNA ONE
DYes [;\fNo DNA ONE
DYes ltNo DNA ONE
DYes 18jNo DNA ONE
DYes ~0 DNA ONE
DYes ~0 DNA ONE
DYes ~No DNA ONE
DYes )9No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
D Yes ~No DNA ONE
DYes ~No DNA ONE
.. :<f.ii.~'~S•o~X~:~-~ , .,,-,, •,,:,ii'J.\l);., WtC,<\!""""~ · '«•• ,,_., ..
t--
-...
11/28104
• r-acilily No. ~~ Lpl{-;-Time In q ~
Farm Name l.)(Y\ ~A ~..S. #\ltD \-')
Time Out Date 12{2...0 I i){p
Integrator cf\ -f>
Owner dho9.A~ SiteRep ShJL\~ ~
No. · fJCjqq Operator S\:v.. \ ~\J'...
. Back~up ------------------: No.--------
COC v:· Circle: General or ~
Design Current Design Current
Wean-Feed
uu .......... t:;"U_c:.h . -c. Eeed -Finish ...., l'h~bO
Farrow-Wean l_o\n~ , ~BOARD: Design-----
Sludge Survey ~I! .V'
crop Yield -~
Farrow-Feed
I --Farrow Finish ·
1 (JJ_ 1 -::,_v Gilts I Boars
Others
Observed ------
Calibration/GPM / 1 / ~--IS" -~
_,c::===.
Waste Transfers ___ _
Rain Gauge___ Rain Breaker___ /
Soil Test ~ PLAT ---=-v/_....;o:::....:I=:C.. Wettable Acres ____ _
Weekly Freeboard ~ Daily Rainfall . ~...:_ \Nt ;~~1t;7~pections _,_...,., ___ _
Spray/Freeboard Drop -------------;~____::......_ _____ _
Weather Codes __ 120 min Inspections __ _
Waste Analysis:
Date Nitrogen (N) Date Nitrogen (N)
Pull/Field Soil Crop Pan Window
Av(~ ~ll Jf M .lb..u ~·~ ~Jt-'i>J~l
~~r ~ too '\ t t'S" -1ol~1 aJ,-3/~
"'" r •
A ·vb ~~-r,~ ..1 iLD \ol'-q '~
"'
\ 'u..l~ 9y ~l't -'-f l'!t0
~{~ ~Lv 1 'OC
... \l \A:(l OLJ.
,.)...)o..D ~l.l Ill_
J tuU.oa+ 1()0 ,,,_ "-//?()
e Dhisio n of Water Quality · .. ·.,::;.:>-,:
· 0 Division of Soil and Water ·conservati o~ 0 Other Agency .. · . ' .. . . ·::~ ·
Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Techni cal Assist ance
Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 17-/~·Of I An-ivai Time: I <f! oo I Departure Time: ~.-1 ___ _,I Co un ty: _5~l!II'.J..Q...!!_ Region : f=ll_o
Farm Name: __ (2'--'--M"'---_f>.p..Jf~ -p-L-C.~----Owner Ema il: -------------
owner Name=---=~_,_~ec/& ___ --~a .HJ Phone:
Mailing Address: __ / 8.:.....:> __ -=r.,v,_p_'f_Cro_il ___ ~/ltl. ___ -~j N!..l~t_ ____ _2_8g_$3_
Ph)'S ical Address:----------------------------------------
Facility Co ntact : --~.b~&l!l._ ___ £,..t;c;//.s_ __ Title: -----------PhoneNo: _________ _
Onsite Represt>nt at i\'C: _S_A~./1-Dif---fJfl,.t/J ______ _
Certified Operator: .S.IJ.el/:,,_ tJ.c..fi:J _____ _
In tegrator:----------------
Operator Certifi cation Number: 17 9_ 1!
Back-up Operator: --------------------Back-up Certification Nu mber:
Locati on of Farm: Latitude: D OD 'D " Longitude: D OD'D"
Design Current Design Current Desi gn Current
Swine Capacity Population Wet Poultry Capac ity Population Cattle Capacity Population
ID Wean to Fini sh 10 Layer
D Wean to feeder
~der to Finish llistro 1&000
D Farrow to Wean
D Farrow to feeder
0 Farrow to Finish
D Gilts
0 Boars -.-... ..
p Non-Layc r I I D DairvCow
D Dairy Ca lf ;
0 Dairy Heife • i
I
0 Dry Cow
I
I
I
D Non-Da iry '
0 Beef Stocker r
D Beef Feeder !
I
D Beef Brood Co"'
I
... ·---
Dry Poultry
Other
0 Layers
0 Non-Lavers
0 Pullets
D Turkeys .
0 Turkev Poults
D Other i Number of Structures: I _~-~' ID Other I
Discharges & Stream Impacts
I . Is an y discharge observed from any pa rt of th e operation? D Yes ~ DNA ONE
Discharge originated at : 0 Structure D App li cat ion Field D Other
a . Was the conveyance man-made? D Yes D No D NA O NE
b. Did the discharge reach waters of the State ? (I f yes. notifY DWQ) D Yes 0 No D NA O NE
c. What is the est imated volume that reached waters of the State (gallo ns )?
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 operat ion?
3. Were there any adverse impacts or potenti a l adverse impacts to th e Waters of the State
oth e r than from a discharge?
D Yes 0 No D NA O NE
D Yes ~DNA O NE
D Yes ~D NA O NE
12/18104 Continued
I Facility Number: s~ -tAr-Date of Inspection 17 -J$16" ]
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 Struc~re 2 Structure 3 Stru cture 4
Identifier: tot #f§
~ l.o~ 41~'
Spillway?: a a ~12 IJo
Designed Freeboard (in): ltJ..'' ,, ,. L'l."'
~
Observed Freeboard (in): ~~~---~-. -~~~~
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion. seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
.~
b. a
.·£'1."'
~u·
DYes B-tcro DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6 ri& ~ .. 3Q.J
llo a.o
(~ ~ -11_ 41
/'3Y , .. ::.:a~x~!·
DYes 81fo DNA ONE
DYes ld1'fo DNA ONE
If any of questions 4-6 were answered yes, and tbe situation poses an immediate public health or environmental tbrea4 notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~ DNA ONE
0 Yes r;;;rrfo DNA ONE
DYes ~DNA ONE
D Yes CJ1c(o" 0 NA D NE
11. Is there evidence of incorrect application? lfyes, check the appropriate box below . 0 Yes G31fo DNA 0 NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence 9;:fin)IJ?rifh.D Application Outside of Area
/4 b V'l 3,':1 :J ')r ) 1 ~ v") Sol ;JJj l(,f /t;J
12. Croptype(s) ~erf¥!vJtt 6-erd5 {Ht~! ~,t,.,s .f,q/1 1-rt:~,'n tv~~{lf
13. Soil type(s) Ar!B Pu,/3 w~_fl;
14. Do the receiving crops differ from those designated in the CA WM P?
15. Does the receiving crop and/or land application site need improvement?
DYes ~o DNA ONE
DYes la'No DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'iD Yes D No 0 NA g.,qE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment'?
DYes 0No DNA ~E
DYes Ea'No DNA ONE
12128104 Continued
I Facility Number:$).. -~'tCI Date of Inspection I ?·fJ·tl?' I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Pennit readily available? DYes DNA ONE
20. Does the facility fail to have all components of the CAWMP readily available? Ifyes, check 0 Yes ~0 0 NA D NE
theappropiratebox. D~ D~ts D~ D~ ~
21. Does record keeping need improvement? If yes, check the appropriate hox below. , ~ D N
1
o DNA D NE
....../ _ _/ J•;J)-' ?-ol-1•8 J~j-),f JO:L -;),~ )1'/·/.1 lfO .,,, 'f•.2·J·<
~Waste Application llJ'\Vee~ Freeboard [i;i'Waste Analysis D-soil An~l~·sis. 0 Waste Transfers D !nmttttl CeFtiite~ttmrt-
~nfall D Stock~ .~rop Yield ~Minute Inspections ~nthly and I" Rain Inspections ~er 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?
trr-tn
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 pennit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
30.
31.
32.
33.
and report the mortality rates that were higher than nonnal?
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
Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
Does facility require a follow-up visit by same agency?
1$ j!~~~.'11j
&~/'/' rd&Jt>d
u..; II ,..~:I a Cdl"y))
Lrcp )','e/,/ ~,.,.,
t-vu.Jk ~ a.~l' I'S
C.d./tr,,J 6-y ct w~k
e;t,.,/ A7dnf17
fu..-/,e~
Jl.
htu,.e HI,,..,
~&~·v•le..
s,·,~~./ II.~
drh·,',..j t:{./1
DYes Gf'No DNA ONE
li&'Yes 0 No DNA 0 NE
D Yes (;31..!o D NA D NE
DYes ~o DNA ONE
0 Yes ilJ1qo DNA 0 NE
DYes 0No DNA ~
DYes
DYes
DYes
DYes
DYes
DYes
11118104
[31(o DNA ONE
Cd1'fo DNA ONE
~0 DNA ONE
~0 DNA ONE
0'No DNA ONE
B'No DNA ONE
. . '. '·!. ' . ·: < .. ,. .~ .
• Compliance Inspection 0 Operation Review 0 lagoon Evaluation
Reason for Visit e Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access
....
-~F_a_c_m_ty_N_um_b..,.e_r _I_B? __ H __ ~_;c ____ .... l Date of Visit: L......;-7-;-~Hi~qr~l T:.:im:e::.!:l ::/0'.::·:;3~0~:!..."""""""'_"""""""~ . Jo Not Operational 0 Below Threshold
g1(rmitted ~rtified [] Conditionally Certified [] Registered Date Last Operated or Above Threshold: ··--·-·--·-···-··
Farm Name: -····--·-····../J.-.~-~---······-~-~.tf. . .?. .... -~-L .. £._ .... -·-··········-·······-·-County: ···-~~..U!l-·····--··-···;r;---··· .. !.:.~!?..-··-·
Owner Name: ···--·-·-·-·---~~df.t?.!:l... ............. ~r.t.tf.S. ...... -·--·····-··········-················· Phone No: ... _.'f/E_-::_.£1.2_-::~'1.2=---··········--····-·-·
Mailing Address: ··-···L.3 ... 1S:: ........ K.. ..... f1c.,x.a.a.._ . ./f.d_ ______ ~ .. ef./.~~---· __ Af.L ....... --2.2.:f..f.."}________________________ ··--·-·---········
'./ f-lo..., ""(
Facility Contact: ··--···········:f! .. b.~!tg_t:J ..... _ ....... ..fJ.Ii':.H..5.._._ Tide: ··-··········-····-····················-···-·······--·· Phone No: __ !tf2::.,;tK.'l::...:l9.f&:_ .... _ ..
Onsite Representative: ··-······J.6.e.Hf.k:l. ....... _____ (3.B.:/Is.. .... _.____________________ Integrator: ___ f!J.!!!.p?..o/-···Ll..a..&¥.!2... ___________ _
Certified Operator: ·-····-·-··---~~.df.t?.tJ _______________ _ll.atf!____________________ Operator Certification N~ber: __ 0 1.!!1 .... ----·
Location of Fann:
~ine D Poultry D Cattle D Horse Latitude .______.I• L..l ---'~ L..l _ ___.I" Longitude ...___.I• L..l _ ...... I· I ·
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: D Lagoon D Spray Field D Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
DYes ~
DYes ~
DYes ~ -
DYes [iJ..Nc:J
DYes QNO
DYes @-NO
Waste CoUection & Treatment __ ./'
4. Is storage capacity (freeboard plus storm storage) less than adequate? 0 Spillway DYes Bflo
StrucLure 1 Structure 2 Structure 3 6structure 4 S~cture 5 t~cture 6
Identifier: ···-····---L~l........ ____ Jo...2.: .... ----__ ..d.o.L.-·--······· ~-~ .... '!E. .... 3Q.J...... . .... ~~-'-C..!t.ol. -·········~!:If!../
Freeboard (inches):
12112103
~ j 1 r ] ' r 1 ':IJ I/ J 4 rr .1:J q 3 ~ ..-,..
Continued
···~·· ,. '
,:.
[Facility Number: fa -(,ttlf' I Date of Inspection I 2-1£ ·<tf
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(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 suuctures 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 maintenancefunprovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
D Excessive Ponding D PAN D Hydraulic Overload D Frozen Ground D Copper and/or Zinc
12. Crop type &c,.,wk J sa,te,: £mel! 6=rf4.·~, "vAI"a+
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
P/eC¥!.e hiO'!,lor lu:ut' J,oo/5 a.-Cl""' c;/ It:-J"" ,_,,_ CvN,,.,fly mvlc/,;,.,J bM~ 5pofs
a,'<7vnd /e-'Jc"'" ./0 e,J,~,t~
11 ~-,.,,..,or Sl'cfs
P/~cr.5~ -/'( 1>'101/(. ~,.., ... /!
Reviewer/Inspector Name
Reviewer/Inspector Signature:
~r.:.s$ <jrow#. ·
of eros.,''? W~-'t! nof,J. Plt".ou r~a.:~ a> n~c~.ucu'y".
W~;~ocfy so/I:..,~.J on IC4, "";~ b~ .. lrJ.
Date:
(g-NO
~0
@-No
~
[9-NO
[31'fo'
[]-NO
8-No
[iJ..bio
[3-NO
g.No
li].No
13-Ko
0No
Q.No
9-Nn
B:No
12112103 Continued
1 Fllcility Number: s2 -tom Date of Inspection 17-tt;¢( J
Required Records & Document."
21 . Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ieJ-WUP,eheeldists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
0 Wasta AppH•auon O~a&:G 0 Wtate Analysi! 0 Soil SampliRg-
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 siruations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified A WMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31 . If selected, did the fac ility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facili ty 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 -steelemg Eotm (g-6op Yield Form 011 'ilr 0-1-nspecdon Aftet 1" R&D
[3120 Minute Inspections 0 Atmwd Cet ti:fteaticft r91a
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
g.yes
~es
DYes
IQ-1'ts
DYes
19"f'es
[J No violations or deficiencies were noted dnring this visit. You will receive no further correspondence abont this visit.
#Jf
'11= 33
12/12/03
OK<>
8-NO
liJ-NO
g.Kc)
8-No
[Q-No
.[9-i'Q'o
~
8*0
ONo
0No
I}Nt)
ONo
~
ONo
'
1
Site Requires Immecliate Attention: N ~
Facility No. ___ _
DIVISION OF ENVIROl\TMENT AL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: I /1z.. , 1995
Time: ___ _
Farm Namc/Owner: _____ t::>::::....:.·..:..M...:...:. . ..:.P&!.:~:..!.~...:....:..::S~-.:..~...1..----------------
Mailing Address: ':5'S'C\ WAC( c_tt.os ~ ~b
County=------~~~~-~~~-~~o~N~-----------------------------------------­
Integrator: ___.-.;.~~~-=--o ....... w:....:"'......;s;.._,.O"f--=-----=CJ:-Q,.....;.a..:.. ... ._.;;;;~..;..;.' ...,'-=--a..:.__________ Phone: <\ ~o I '-«\ ~ -~G-oo
On Site Representative ; ____ =s"'""'~~:..:.\~-=o~""::::......-~_;...... .... .;;.;....;,~...:...~ ..::;.$> _______ Phone: ctlo. { L.CO'\. -"iS~w
Physical Address/Location: -----~...w..:~~---'~'•' ,.,:...... __ _:t'f\;..;.;:;..:~~G~,;;;"';;..;o:....::'-;:_:'.:;;;C~~.~-------------
' Type of Operation: Swine _1L Poultry_ Cattle_
Design Capacity: -------Number of Animals on Site:
DEM. Cenification Number : ACE OEM Certification Number. ACNEW __ _
Latitude: __ • _. __ " Longitude:_._._.,
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot+ 25 year 24 hour storm event
(approximately I Foot + 7 inches) @or No Actual Freeboard: (o Ft. _2_ Inches
Was any seepage observed from the I~n(s)? Yes or@ Was any erosion observed? Yes or@
Is adequate -land available for spray?~r No Is the cover crop adequate?@or No
Crop(s) being utilized :--------------------==~---­
Does the facility n;eet SCS minimum setback criteria? 200 Feet from Dwelli~@or No
. 100 Feet from Wells'?~r No
Is the animal wa.~te stockpiled within 100 Feet of USGS Blue Line Stream? Yes o@
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes o@
Is animal waste disc harged into waters of the state by man-made ditch , flushing system, or other
similar man-made devices? Yes o~ If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? @or No
Additional Comments: V.~cc."~"f'E.~~l) 1 ~o"-"-1:>"'-''t-:~~ ~''"·:~ 's 1 -to be:... c.crt~-€~~ \'1
\..\ ~"'""'-!. \ ""i/Lt CU-4'e,... \o...cc,o o...S
Inspector Name SignatUre~
cc: Facility As&e$sment Unit Use Attaclunents if Needed.
.. MAGNOUA
· ..... POP. S92
. ~· ~-~ ... ;.··C·.:=~-:~.a :-· :: .. ~ •
..
. . ..
. . . ~: ·' :
.. : -. -.
.-... ;;_: . .->.'·.' ... ·,.·
a . JJ· ~ 1120 •
" • 0 ••
DIRECTIONS: FROM MAGNOLIA TAKE STATE ROAD I 1003 TOWARDS
DELWAY, APPRO X: 4 MILES FROM MAGNOLIA TURN RIGHT ON TO STATE ROAD
# 1117, FARM ENTRANCE WILL BE APPROX: 3 MILES ON THE RIGHT.
MAll.lNG ADDRESS:
DM BATTS FARM . I ~t~
359 WAYc:ROSS ROAD LJ'r\~])
MAGNOLIA, NC 28453
HOME TELEPHONE: [phone]
SHIPPING ADDRESS:
MR. SHELTON BATTS
STATE ROAD # 1117
MAGNOLIA, NC 28453
DRUWN"S UF CAROLINA. INC..
JUJ F.I\Sf (..'ULLEGE Sl"Rl:.fiT • I' .0. U()X' -!1!7 • WAlt SAW, N.C. 21:1J98-~87 • OFACE: (gl9) 29~ll81 • FAX: {919} 29J-4726
Sjte Requires Immediate Attention: _&._
Facility No. ___ _
DIVISION OF £NVIRONMENT AL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: I [ rz_ , 1995
Tjme : ___ _
Fann Name/Owner: t>. M. · '?.:>~'"\\~ -"E
Mailing Address: ~ "S g W"t c...ns,. J;d, ~ \q_~'"t f'1.,~{'e\.:..._ ~c.. £..~1-lS" S
County: ~ \"\ f"l v -so ""'
Integrator: B~ow""s ~ c:_A.~o &....\...,~ Phone: 4\\0 ["Z..f\.~-~<Doo
On Site Representative: "5 "'-.. \~ .. "' '§,"\\-$-Phone: q_lo. I ~so. -'le¥s
Physical Address/Location : ~~ \\ \., w .a15 t'\~r-o\.-.
' Type of Operation: Swine _!L Poultry_ Cattle_
Design Capacity: -------Number of Animals on Site: --=-~.:.::a:....:e::....o ____ _
DE.t\1 Cenification Number: ACE. __ _ OEM Certification Number: ACNEW __ _
Latitude: __ • .. Longitude :_. __ ._.,
Circle Yes or No
Does the Animal W astc Lagoon have sufficient freeboard of 1 F()()( + 25 year 24 hour stonn event
(approximately 1 Foot+ 7 inches) @or No Actual Freeboard: tO Ft. o Inches
Was any seepage observed from the I~n(s)? Yes or@ Was any erosion observed? Yes or@
1s adequate land av.Ulable for spray?~r No Is the cover crop adequate?@or No
Crop(s) being utilized:--------------------=~--­
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelli~@or No
. 100 Feet from Wells?~r No
Is the animal wa.~re stockpiled within 100 Feet of USGS Blue Line Stream? Yes o@
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes o@
Is animal waste discharged into waters of the state by man-made ditch, flushing syst.eJD, or other
similar man-made device!~? Yes o@ If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure. land applied,
spray irrigated on specific acreage with cover crop)? @or No
AdditionalCo.mments: Ke..~,~te..~~ ~ fo\\e-..~ . .,fa ~C\1\."t>\s "to \a'-c:..Jt.'r't..€ .. ~)ctl
~ v ~ ' \~I""\: <II.. c...-,. L-\ "-()P -!). 4.
Inspector Name
cc: Facility Assessment Unit Use Attachments if Needed.
'
..-.·-~ !.::.':".o. ..........
.:t ,;. ..
-'--:.·. I -.,.., "'0: .. -;J .....
I ., ......
..
a
. 1.7• ~ill..Q. -
....
. · . MAGNOUA
. ·. ·:.: :P?~·. S9_2
~.. ·· ... ·~·-·i.·.::!·:: :~: .. ~:
-. . : ~. :
. . ... ~ ( .·• . : . . ~ : :· .. ·. . . . . .
' . . :.
DIRECTIONS: FROM MAGNOLIA TAKE STATE ROAD # 1003 TOWARDS
DELWAY, APPROX: 4 MILES FROM MAGNOLIA TURN RIGHT ON TO STATE ROAD
I 1117, FARM ENTRANCE WILL BE APPROX: 3 MILES ON THE RIGHT.
MAILING ADDRESS:
DM BA'rrS FARM . I ~t4
359 ~AYCROSS ROAD LJ'•tJWg)
MAGNOLIA·, NC 28453
HOME TELEPHONE: [phone]
DRUWN"S OF CAROLINA. INC.
SIDPPING ADDRESS:
MR. SHELTON BATTS
STATE ROAD # 1117
MAGNOLIA, NC 28453
JO.l F.A.IT (."ULLJ\(i E S"rRUfiT • I' .0. UO:'(' -41\7 • W ,\lt!iAW. N.C. 2lSJY8-W87 • OFFICE: (919) 2YJ-21 81 • FA.'<: ('1 19} 29>-4726
.,.
Site Requires Immediate Attention: ...tilL
Facility No. ___ _
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SI1E VISITATION RECORD
DATE: I /a-z._ , 1995
Time: ___ _
Fann Name/Owner:· 't>f\'\. ~A"\\S C
Mailing Address: ~ SC\ W"-'f C-$it..o*S '\'O!:...t:> c;~ \~~"t 1\1\.~G ...,~""'A ·\Jc.. "2..91.\~ s
County: -sl"\0'\V'S' o"'
Integrator: __ B._~-=-o_w_ ..... s_~.._:___;c:...J=A-tit..:...:;..o..;'-;;;.:\:...:.....,::...,..._;,_------Phone: C\ ~o {7...'\ '!.-~<Doo
On Site Representative: S\,1:.\.."('&.~ 1!."'-~S Phone: ~\0 l 3-e'-~ec..c.
Physical Address/Location: __ __,:~~~..:;:::...-'..:..'=-'=-'-=--~---=~t-l::=o-'-;...;:\:...:.~.;__ __________ _
' Poultry_ Type of Operation: Swine _lL
Design Capacity: -------
cattle-
Number of Animals on Site: -~~'"l._o_o _____ _
DEM Cenification Number: ACE OEM Certification Number: ACNEW __ _
Latitude:_._._.. Longitude:_. __ ._.,
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot+ 25 year 24 hour storm event
(approximately l Foot+ 7 inches) @or No Actual Freeboard: 7 Ft. ___£__Inches
Was any seepage observed from the l~n(s)? Yes or@ Was any erosion observed? Yes or@
Is adequare land available for spray?~r No Is the cover crop adequate?@or No
Crop(s) being utilized:-------------------~=----­
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelli~'@or No
100 Feet from Wells?~r No
Is the animal waste stockpiled wirhin 100 Feet of USGS Blue Line Stream? Yes o@
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes at@
Is animal waste discharged into waters of the state by man-made ditch , flushing system. or other
similar man-made devices? Yes o@ If Yes, Please Explain .
Does the facility maintain adequate waste management records (volumes of manure, land applied,
··spray irrigated on specific acreage with cover crop)? @or No
Additional Cormnents: ___ c.e..=r~t~,~fu..,s.d.s::... ________________ ~--
Inspector Name
cc: Facility Assessment Unit Use Attachments if Needed.
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S FARMS (SHELTON BATTS)-8 (720) FINISHING
STATE ROAD #1117-DUPLIN COUNTY
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DIRECTIONS: FROM MAGNOLIA TAKE STATE ROAD # 1003 TOWARDS
DELWAY 1 APPRO X: 4 MILES FROM MAGNOLIA TURN RIGHT ON TO STATE ROAD
# l.l.l. 7 1 FARM ENTRANCE WILL BE APPRO X: 3 MILES ON THE RIGHT·
MAILING ADDRESS:
OM BATTS FARM . I '1t4
359 WAYc::ROSS ROAD (_y ,t.f!.isF'J)
MAGNOLIA, NC 28453
HOME TELEPHONE: {919) 289-3866
SHIPPING ADDRESS:
MR. SHELTON BATTS
STATE ROAD # 1.117
MAGNOLIA, NC 28453
DIWWN'S OF C,\ROLINA.INC.
JI)J F.I\Sf (.'(JLLI;GE STR(;JIT • 1'.0 . IJOX' 4117 • WAI(SAW, N.C. 2!1]98-0437 • OFRCE: (9 I'J) 2 ;J.l iSI • FAX : [phone]
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Site Requites Immediate Attention: .N'o
Facility No. ___ _
DIV!SION OF £NVIRONMENT AL MANAG~!
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: I L1-z... , 1995
Time: ___ _
Fann Name/Owner:..,.--___ t>~tv\.--=-___,~~~P.:....:~~-r-~:s---_..!!!t:>~-------------
Mailing Address: ~~C\ Wftl.'1 c..11t.,.o-ss li!:..t:>
County: ______ -s __ ~-~-v~~~o_N _____________________________________ __
Integrator: _-.;.B.:::....;..;~:...:<>...:w.:.."".:....:;.s_;..~__:_..:::c..;:.....A...:...tlt..:..""-:=.'-.;..;\ "'-'..;:.__":________ Phone: ~ lO I "Z..f\ ~ • ~~o
On Site Reprcsentati ve : 5 "'-&.\-Tow "R,., ~ Phone: ct 'o I :z.ect -s9c...r.r
Physical Address/Location: ____ <s...:::o...:Rc:::o.....-.~\u\....,}~7 __ _.;.fti\....:-._G.......,"''""o....;;;:'-:.;....;'_._.;. _________ _
' Type of Operation: Swine ~ Poultry_ Cattle_
Design Capacity: -------Number of Animals on Site: _~_-z.._o_o _____ _
D&.'\1 Certification Number: ACE __ _ DEM Certification Number: ACNEW __ _
Latitude: • ___ " Longitude: __ • ___ .,
Circle Yes or No
Does the Animal Wasre Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour stonn event
(approximately 1 Foot + 7 inches) @or No Actual Freeboard: 7 Ft. o Inches
Was any seepage observed from the l~n(s)? Yes or@ Was any erosion observed? Yes or@
Is adequate land available for spray?~r No Is the cover crop adequate?@or No
Crop(s) being utilized:-------------------~---­
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelli~@or No
100 Feet from Wells?~r No ·
Is the animal wa.'\te stockpiled within 100 Feet of USGS Blue Line Stream? Yes o@
Is animal waste land applied or spray irrigated within 2S Feet of a USGS Map Blue Line? Yes o@
Is animal waste discharged into waters of the state by man-made ditch , flushing system, or other
similar man-made devices? Yes o@ If Yes, Please Explain .
Does rhe facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific ac~e with cover crop)? @or No
AdditionalComments: C.~<-t.~:-d. "\ ~ .... " .. s \ '1!4. 0..'-f<-\o..~oo'("\
Inspector Name
cc: Facility Assessment Unit Use Attachments if Needed.
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DIRECTIONS: FROM MAGNOLIA TAKE STATE ROAD # 1003 TOWARDS
DELWAY, APPRO X: 4 MILES FROM MAGNOLIA TURN RIGHT ON TO STATE ROAD
# 1117, FARM ENTRANCE WILL BE APPROX: 3 MILES ON THE RIGHT.
MAILING ADDRESS:
DM BATTS FARM . /~t4
359 ~AYCROSS ROAD LI·t~J)
MAGNOLIA, NC 28453
HOME TELEPHONE: [phone]
SHIPPING ADDRESS:
HR. SHELTON BATTS
STATE ROAD # 1117
MAGNOLIA, NC 28453
DROWN"S OF Ci\ROLINA. INC.
Jll.\ EAST c,:oLI.H<il~ STRt:IIT • 1'.0. UO .\' o.IK7 • W,\JtSAW . N .C. 2 ~J\J8-U+87 • OFRCE: (919) 29J..2!81 • FAX : (919) 29H726