820653_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quality
Date of Visit: ~/?-J if'
Farm Name: "Jt-,c/1«"-
Arrival Time: I Cf.' tJ 0
5/z::-r-) E?!r;v-
DepartureTime:l /~.G 0 I County:'""~,_... Region: t='l<T>
~ <::!C:::. Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field
a. Was the conveyance man-made?
Phone:
0 Other:
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: fon~l)
Certification Number: 17,-/0
Certification Number:
Longitude:
DYes ~o DNA ONE
0 Yes 0No DNA ONE
0 Yes 0No DNA ONE
d . Does the discharge bypass the waste management system? (If yes, notify DWR) 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 adv erse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes
DYes
~ DNA ONE
E:fN'o DNA ONE
11412015 Continued
,!Facility Number: @_ -41fl
Waste Collection & Treatment
I Date of Inspection: 7-/ <f·-/PI
\ 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. Ifyes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): j Cf
Observed Freeboard (in): 'CJ--
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~ DNA ONE
0 Yes 0 No D NA D NE
StructureS Structure 6
D Yes Ef'No D NA D NE
/
D Yes 0 No 0 NA D NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ~ 0 No 0 NA 0 NE
8. Do any ofthe structures lack adequate markers as required by the permit? 0 Yes ~ 0 NA 0 NE
(not applicable to roofed pits, dry stacks , and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~o DNA ONE
DYes~ DNA ONE
I I. Is there evidence of incorrect land application? lfyes, check the appropriate box below. D Yes ~ D NA D NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN > 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/S ludge into Bare Soil
·D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approv ed Area
12 . Crop Type(s): $?"'tln-i·lJl"\ /c i '-r~~-:tz-rJ / C.ul" n_/-f ar/~1 ,/ 1(/j...-:e*bu -r/~
13. Soil Type(s): kU a. l: / &A I / BfJ:E
'
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site ne ed improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
0WUP Ochecklists 0 Design D Maps D Lease Agreements
DYes c::rNo DNA
DYes ~0 DNA
DYes ~0 DNA
DYes EJ1'io DNA
DYes EfNo DNA
D Yes [j"No DNA
DYes ~ DNA
Dother:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes c:rN'o DNA ONE
0 Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Weather Code
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspectio ns 0 Monthly and I" Rainfall In spections 0 Sludge Survey
22 . Did the facility fail to install and maintain a rain gauge? D Yes ~ 0 NA D NE
23. If se lected, did the facility fail to install and maintain rainbreakers on irrigation equipment? D Yes ~ 0 NA 0 NE
Page1of3 114/1015 Continued
.I Facility Number: $'2---kR !Date oflnspection: Z-/9 -;PI
24. Did the facility fail to calibrate w;ste application equipment as required by the permit? ' 0 Yes ~o 0 NA 0 N E
• 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ~s 0 No 0 NA 0 NE
the appropriate box(es) below.
[2J'Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
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, fi-eeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field D Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/lnspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
7 P,'f.... ::z~t"-z::_ ~&:"t!L ~C'/t;5~i.J--C/-:h--!.7 ...... ~-·-;J>J.,_
0 Yes
0 Yes
(?{No
0'No
DNA ONE
DNA ONE
DYes ~o DNA ONE
0 Yes [3"No
DYes
0 Yes
0 Yes
0 Yes
DYes
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
-= -j. I 70 do o-n n.vo.J...____ :5 Lv)%-::c-.r.~~*~ ra-/'rt"f_ , ~., .,..~ V'
Reviewer/Inspector Name: 57Er::-e__.~~ .
Reviewer/Inspector Signature: d ..-i-e'<~'-/.___
~ ?
Page3 of3
Phone: 9(o-.3?.>3-o/..5"'/
Date: 2·-/2 ~~
2/412015
I
~
ompliance Inspection Operation Review 0 Technical Assistance
Reason for Visit: 9'1foutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I hV:J/1 Arrival Time: I 10~ '-')!{" I Departure Time: I Z2 , ' /L
tkr>'at.-'~ ZkYJ ~~ m. ~
I countyQrr:--Region: CEQ
Farm Name: Owner Email:
.;v =
Owner Name: ~h-~) 6,.-~
C>
Phone:
Mailing Address:
Physical Address:
J!!:f(5fol Facility Contact: ~~ ~~ Title: Phone:
Onsite Representative: ~ Integrator:
Certified Operator: ~ c;-r;-~ J
:>
Certification Number: ...._1~?-2'-'J<....::::D:;..._ ____ _
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at : 0 Structure 0 Application Field
a. Was the conveyance man-made?
D Other:
b. Did the discharge reach waters ofthe State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
Certification Number:
Longitude:
DYes ~o
DYes 0No
DYes DNo
d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a di sc harge?
Pagel of3
•• •'·•·.. ~ • 4
DYes ~No
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21412015 Continued
I Facility Number: ,8P--?,£:2 I nate of Inspedion: ?-2 3' -,?Zoi;"t
Waste CoUection & Treatment
~ 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 37
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes [LJNo 0 NA 0 NE
0 Yes D No 0 NA D NE
Structure 5 Structure 6
0 Yes [3.No 0 NA 0 NE
0 Yes cgj No 0 NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public bealtb or environmental tbreat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
D Yes I2?J No D NA 0 NE
1l.ls there evidence of incorrect land application? Ifyes, check the appropriate box below. 0 Yes [8.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): ,~Jc:L bvrY?~ /r:oC!"n .
1
/¥-.t!w.lr/J.!2tr!lcT.
13. Soil Type(s): tVcKD
1
/ +< 6 / h p
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 t:ick of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
OwuP Ochecklists 0 Design 0 Maps D Lease Agreements
DYes [2iNo
DYes [BJ. No
DYes ~No
DYes uaNo
DYes §No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~No 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Page 2 of3
DYes ~No 0NA ONE
21412015 Continued
!Facility Number: £;?: -t,,£3 I Date of Inspection: (':; ~ .e1:> llf
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 8}-No 0 NA 0 NE
DYes ~No DNA ONE
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date offrrst survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? O Yes ~No DNA O NE
27. Did the facility fail to secure a phosphorus Joss assessments (PLAT) certification? DYes £J No DNA O NE
Otber Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes taNo 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? 0 Yes ~0 DNA ONE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notifY the Regi~nal Office of emergency situations as required by the D Yes [8).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. D Yes ~0 DNA ONE
0 Application Field 0 Lagoon/Storage Pond 0 Other: -----------------------
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature :
Page3of3
DYes QJNo DNA ONE
DYes rn:,.No DNA ONE
0 Yes ~0 DNA ONE
Phone : tzo-J0.3-Z>fs-l
Date : 0 -?,"j-,.,;2i)J7
21412015
'-~~~~~~~~~~~~~=~~~~~ ompliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ~ine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I ~ J ?= /tj Arrival Time:! It?: 0 0 I
FarmName: Jirt?·JHJ!-1 >~~ ~,-,.,.__
Departure Time: I$,' 15:
~
lcounty:_5"~ Region:
Owner Email:
Owner Name: fZP~) F #/ JY'-Phone:
Mailing Address:
Physical Address:
Facility Contact: --loc/z...::.:~tloL.:...t'..L/a.;,,~-t"---Lc:....:..,..~Y:"------Title: /If~
Onsite Representative: ___ __.(t;....:;..A:.-<..c_.===-------------
Phone:
Integrator: ~~~~~~ -
Certified Operator: }(../~ /( le===--: Certification Number: .:o2t>~~0:;........:9:......,1:-___ _
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? DYes ~No
Discharge originated at: 0 Structure D Application Field D Other:
a. Was the conveyance man-made? DYes DNo
b. Did the discharge reach waters of the State? (If yes, notify DWR) DYes 0No
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes DNo
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes ~No
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
1/412015 Continued
!Facility Number: tp=-?, 0 loate of Inspection: dJ?-/t-:;:zi>N
Waste CoUection & Treatment
-\ 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes , is waste level into the structural freeboard?
Structure 1 Structure2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in): I;J:
Observed Freeboard (in):
5. Aie there any immediate threats to the integrity of any of the 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 Qg.No DNA D NE
D Yes D No D NA D NE
Structure 5 Structure 6
DYes _3.No DNA ONE
D Yes ~No DNA D NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Aie there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
DYes ~No 0 NA 0 NE
DYes ~No DNA ONE
DYes ~o DNA ONE
I I. Is there evidence of incorrect land application? lfyes, check the appropriate box below. 0 Yes j;a No 0 NA 0 NE
D Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Aiea
12. Crop Type(s): fhr/"'tnula-!ot/t''df>-rj ko/' rt_ h '7'~ /tuhrzd-,1/?"l;-fk T
13. SoiiType(s): J#ap 1/tulf / $'().15
v '
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
OwUP Ochecklists 0 Design D Maps 0 Lease Agreements
DYes f3No
DYes ~No
DYes @No
DYes (g. No
DYes ~No
DYes ~No
DYes IEJ.No
00ther:
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections 0 Sludge Survey
DYes ~No
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~No 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes (il..No 0 NA 0 NE
Page 2 of3 214/2015 Continued
.• ~acility Number: 17=-b.'.,-:3 I lnate of Inspection: ,;r:-;']1-/fD/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.
D Yes {2g No D NA 0 NE
DYes ~No DNA ONE
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notifY the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field D Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
DYes ~No D NA ONE
DYes J:&No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes SNo DNA ONE
DYes ~No DNA ONE
DYes N No DNA ONE
DNA ONE
DYes DNA ONE
Phone: Jzv -qp-ft Do
Date : ;r-//--,2[)/6
21412015
~ff'l--r-;:r-Js-
~~~~~--~--ompliance Inspection
Reason for Visit: ~tine 0 Complaint 0 Denied Access
Date of Visit: I a-=-p -;!fT Arrival Time: I L / u u I Departure Time: Ill! ~12 I County: 5_7 trt--Region:
vi~~ /)r~ &1?'1-~ OwnerEmail: Farm Name:
Owner Name: Phone:
Mailing Address:
PhysicalAddr~s: ----~---------------------------------------------------------------------------­--(J......;..--=..~~,.;.L£..!......,;f"--....:L~r""""'r::"""-----Title: ~d~ Facility Contact:
j/
Onsite Representative: ......_, ... ~:...~-'-------------------------------­
Certified Operator: .If/;//;.--V~~
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field D Other:
a. Was the conveyance man-made?
b . Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: ---t.m~.....:oP!::;;..... ___________ _
Certification Number: /'-0£1t.f
Certification Number:
Longitude:
DYes ~No DNA ONE
DYes 0No 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
~No DNA ONE
(».No DNA ONE
214/2014 Continued
1. I Facility Number: zy -(qo I I nate of Inspection: F;?-JY"'I
W.aste CoUection & Treatment
' 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure l Structure2 Structure3 Structure 4
Identifier :
Spillway?:
Designed Freeboard (in): IL
Observed Freeboard (in):
5. Are there any immediate threats to the intcbrrity of an y of the structure s 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 SNo DNA O N E
D Yes D No D NA 0 NE
Structure 5 Structure 6
D Yes llJNo 0 NA 0 NE
DYes ~o DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any ofthe structures need maintenance or improvement?
8. Do any of the 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 man age ment sys tem other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes {BNo
0 Yes I2J No
DYes 0No
D NA ONE
DNA ONE
DNA ONE
D Yes jB No D NA 0 NE
11. Is there evidence of incorrect land application ? I f yes, check the appropriate bo x below. DYes ~No DNA 0 NE
0 Ex cessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn , etc .)
0 PAN 0 PAN > 100/o 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 Appro ved Area
I2.CropType(s): ])qtnwfrL /pvY/3-r-e~ /co,.-x. 15ryc6'~ /PvJY/ k,~!fo/
13 . Soil Type(s): ~::D / dkJJ / 1Jt~8
I
14 . Do the receiving crops differ from those designated in the CA WMP?
15 . Does the receiving crop and/o r land application site need improvemen t?
16 . Did the facility fail to sec ure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for la nd 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 ha ve all components of the CA WMP readily avai lable? If yes, che ck
the appropriate box.
DWUP 0check1ists 0 Design 0 Map s 0 Lease Agreements
DYes ~0 DNA
DYes ~No D NA
DYes Q9No DNA
DYes (:8No DNA
DYes ~No DNA
DYes ~No D NA
DYes [g( No DNA
00ther:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes jg) No DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 So il 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 fail to install and maintain a rain gauge? 0 Yes ~No 0 NA 0 NE
23 . If selected, did the facility fail to install and main tain rainbreakers on irrigation equi pment? D Yes (3 No D NA 0 NE
Page 2 of3 21412011 Continued
I
jFacili!I Number: ~-~.DI !Date of lnsl!ection : 5-t_~-~s I
24 . Did the facility fail t~ calibrate waste application equipment as required by the permit? Q Yes [ZiNo D NA O NE
25 . Is the facility out of compliance with permit conditions related to sludge ? If yes, check 0 Yes ~No D NA ONE
the appropriate box(es) below.
0 Failure to complete annual sludge survey 0Failure to develop a POA for s ludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance :
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality represe ntative immediately.
30. Did the facility fail to notify the Regi ona l Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31 . Do subsurface tile drains exist at the facilit y? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fai l to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/I ns pector Name:
Re viewer/Inspector Signature:
Page 3 of3
QYes ~No DNA ONE
QYes ~No D NA O NE
QYes l2J No DNA O NE
QYes ~No D NA ONE
DYes 12} No DNA ONE
DYes 18) No D NA ONE
DYes ~No DNA ONE
DYes S No DNA ONE
0 Yes EtJ-No DNA ONE
Phone: 9/P-fJJ-.J3tYD
Date : a:-/ C -1._!>-
214/201 1
Reason for Visit: ~tine 0 0 Other 0 Denied Access
Date of Visit: 1/0'3-It{ I Arrival TimedCZ'!3'0 Departure Timed If).' DO I County:~ Region: FED
Farm Name: JTheh:u&~ , S L~ 61'1'1.-_:p::: e:L Owner Email:
Owner Name: 5tt-rJ f5?,.nu ;J:::nc. Phone:
Mailing Address:
Physical Address: ---=-----------------------------------------
d~,/~ Lz: Title: .R/~,~~ ~~~~~~----------t7 Facility Contact: Phone:
Onsite Representative: -S:~P...~:::='=;__---------------Integrator: //1~ pr'1t..VM-
Certification Number: ~?o;__--~:?;.....;q-;...q-'------Certified Operator: ..... U&:....:..'Lf:....:h:....~ __ ...:....=_........,t!.Z:.....~~~J~~---------
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? DYes I8.._No DNA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other:
a. Was the conveyance man-made? 0 Yes 0No DNA ONE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) 0 Yes 0No DNA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) O 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?
Page I of3
DYes
DYes
~No DNA ONE
~0 DNA ONE
11411011 Continued
-I Facility Number: I Date of Inspection: I o-3 -I J(
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:
Spillway?:
Designed Freeboard (in): I q
Observed Freeboard (in): SJ/
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 mana ged through a
waste management or closure plan?
0 Yes [g No 0 NA 0 NE
D Yes 0 No 0 NA D NE
StructureS Structure 6
DYes SNo DNA ONE
DYe~ ~No DNA ONE
If any of questions 4-6 were answered yes, and tbe situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the 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 o ther than the waste stru crurcs require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes [&.No 0 NA 0 NE
DYes mNo DNA ONE
0 Yes ~No 0 NA 0 NE
DYes ~No DNA ONE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes jg_ No 0 NA 0 NE
0 Excessive Ponding 0 Hydrauli c Overload D Frozen Ground D Heavy Metals (Cu , Zn, etc.)
0 PAN D PAN> 10% or lO lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area
12. CropType(s): T>ecnwJ~L/&-v«~--,.,/ /co/A fs'7~i-e-=, / tuh.-,:l-/n,, ... /J.-7-
13 . Soil Type(s): Wa]? JA-K-e /po '& .
I 4. Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily avai lable?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box .
OwuP 0 Checklists 0 Design D Maps 0 Lease Agreements
0 Yes J;a No DNA
DYes uctNo DNA
DYes IR.No DNA
DYes ~No DNA
DYes ~No DNA
DYes j$No DNA
DYes ~No DNA
00ther:
ONE
ONE
ONE
ONE
ONE
ONE
.ONE
21. Does record keeping need improvement? If yes, check th e appropriate box below. DYes !)tNo 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~No 0 NA 0 NE
23 . If selected, did the faci lity fail to install and maintain rainbreakers on irrigation equipme nt? D Yes rn No DNA D NE
Page 2 of3 2141201 I Continued
-!Facility Number: l Date ofJ nspection: I -o :3-/ B
24. Did the facility fail to calibrate waste application equipment as required by the permit?
.. 25. Is the facility out of compliance with permit conditions related to sludge? If yes , check
the appropriate box(es) below .
0 Yes ~ No 0 NA 0 NE
0 Yes fiY.. No 0 NA 0 NE
0 Failure .to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge lev els 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 ope rator 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 high er 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 repre sentative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required b y the
permit? (i.e., discharge , freeboard problems, over-application)
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes ~No DNA ONE
DYes ~No DNA ONE
DYes QlNo DNA ONE
DYes QaNo DNA ONE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32 . Were any additional problem s noted which cause non -compliance of the permit or CA WM P?
33. Did the Revi ewer/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 o/3
0 Yes .®No DNA ONE
0 Yes J:i No DNA ONE
DYes ~0 DNA ONE
Phone: 9/k' -~-.7J'C;p
Date : 112-3-AIJf
2141201 I
ompliance Inspection Operation Review 0 Structure Evaluation
Reason for Visit: ~tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency
Date of Visit: I Cf£-13 I Arrival Time: I l 0 ~De::> ~arture Time: I 12= :o 0 I County: ~~~ Region: r~ 0
Farm Name: ~oaze.> . ~frr J GhY'--;;:z-Owner Email:
Owner Name: 4 frr) rA/'rn._f :s Phone:
Mailing Address:
Physical Address: --t---------------------------------------
...;tl::;;.. .. .....:;.,.,. "'-'//..c:;..t~~A""---'f__~~;:;,..,L,.r _____ Title: ~l?t~~~;.;J~~;;--___ _ Facility Contact:
}'
Onsite Representative: _...::5.;.:~='""~""=----------------
Certified Operator: II/([(;~ f p-f.,.-j
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
l. Is any discharge observed from any part of the operation?
Di scharge originated at: 0 Structure D Application Field 0 Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes , notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: /lfw-wfo pi""JUV-
1
Certification Number: p9[12{ c:r't
Certification Number:
Longitude:
DYes ~No DNA O NE
D Yes 0 No DNA ONE
D Yes 0No DNA ONE
d . Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes
DYes
~No DNA ONE
~No DNA ONE
214/1011 Continued
I Facility Number: 1ft?= -/;Q I
'• Waste Collection & Treatment
I Date of Inspection: CJ= (;.-1::5
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure2 Structure3 Structure 4
Identifier :
Spillway?:
D esigned Freeboard (in): [Cj"
Observed Freeboard (in):
5. Are there any inunediate threats to the integrity of any of the structures observed?
(i.e., large trees , severe eros ion, seepage, etc.)
6. Are there structures on-si te which are not properly addressed and/or managed through a
waste management or c losure plan?
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
0 Yes ~No D NA 0 NE
0 Yes li(1 No 0 NA 0 NE
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 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 [8 No D NA D NE
D Yes ~ No D NA D NE
0 Yes GQ No D NA 0 NE
DYes ~No DNA ONE
II. Is there evidence of incorrect land applicatio n? If yes, check the appropriate box below. 0 Yes ~No D 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 Acceptabl e Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. CropType(s): l?r!rmd~ltltl~r:drd lt!arnl 5Ryd~,r-u. /w/,//ai/~7:
13 . Soil Type(s): /dla}? l4-u]r /PaP
14. Do the receiving crops differ from those designated in theCA WMP?
15 . Does th e receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
Required Records & Documents
DYes J;gl_N o
DYes ~No
DYes 1&1 No
DYes fBl No
DYes ~No
DNA
DNA
DNA
DNA
DNA
ONE
ONE
ONE
ONE
ONE
19 . Did the facility fail to have the Certificate of Coverage & Permit readily available? 0 Yes [21 No 0 NA 0 NE
20 . Does the facility fail to have all components of the CA WMP readily available? If y es, check D Yes 18}. No 0 NA 0 NE
the appropriate box.
OWUP 0Checklists 0 Design 0 Maps 0 Lease Agreements Dother: _________ _
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No DNA D NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analys is 0 Waste Transfers 0 Weather Code
0 R ai nfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? D Yes 0 No 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No 0 NA 0 NE
Pagel of3 21412011 Continued
I Facility Number:
/
!Date of Inspection : ""t-~t,--1'3
\ ' 24. Did the facility fail to calibrat e waste application equipment as required b y the permit'! DYes Ji1 No
(
DNA ONE
DNA ONE 25 . Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes ~No
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an acti vely 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 th e inspection did the facility pose an odor or air quality concern?
lfyes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situati ons as required by the
permit? (i.e., discharge , free board problems, over-application)
31. Do subsurface tile drain s exist at the facility? If yes, check the appropriate box below.
DYes ~No
DYes ~No
DYes (8iNo
0 Yes ~No
0 Yes lidNo
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the p ermit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss revi ew/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
DYes ~No
DYes f2Y.No
0 Yes [g) No
DNA ONE
DNA ONE
DNA ONE
0T 8Dy Other ._UIJ.IWio;U'l3
.~~ :· . ; ··~t·.. ;.
Phone : ~~.JJ-..3.3 a:>
Date: iecr-t;--~8
21411011
OOther
Date of Visit: l""\\%>\\~ I Arrival Time:loY)~t:\5' Departure Time: I \O.Q:J Af'\ I County~~ Region: FRO
Farm Name:Pr'Of'l'.i?t-5 &rtta Fei\M :k:l d.. Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: ----------------------------------------------------------------------------------
Facility Contact: c·'-'er,a..\LS \...£,.£... Title: \J\oot.~ 2.
Onsite Representative:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field
a. Was the conveyance m a n-made?
0 Other:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Certification Number:
Certification Number:
Longitude:
DYes ~o
DYes 0No
DYes 0No
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State othe r than from a discharge?
Page I of3
DYes [2(No
0 Yes 0No
DNA ONE
~NA ONE
~NA ONE
[?NA ONE
DNA ONE
DNA ONE
114/1011 Continued
(Facility Number: (Date oflnspection: , /~lA
Waste CoUection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): _l.._Cj...J...---
Observed Freeboard (in): ~
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
DYes 0No [3'NA ONE
Structure 5 Structure 6
DYes ~No DNA ONE
DYes SNo DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes
DYes
~No
[3"No
DNA ONE
DNA ONE
0 Yes G(No DNA D NE
0 Yes [3'"No DNA D NE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes [S?'No DNA D NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs. ~tal Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Wind~U Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): ~'t..R~~ ~ JoU'LB;S~£..0
\ \ 1
13. Soil Type(s): w~b \A.,~, 1!m~
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
Page 2 of3
0 Yes [i6"No
DYes U(No
DYes ~No
DYes rn"No
DYes 8No
DYes ~No
DYes SNo
Oother:
0 Yes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
2/412011 Continued
!Facility Number: I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes ~o DNA ONE
DYes ~o DNA ONE
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other:
DYes [B'No DNA ONE
DYes [g'No DNA ONE
DYes U?'No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~0 DNA ONE
------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes !Jd"No DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes s'No DNA ONE
any YES answers and/or any additional recommendations_
situations (use additional
Reviewer/Inspector Nam e:
Reviewer/Inspector Signature:
Page 3 of3
Phone : C\\p-~'P,. L .~S]
Date: \\ ro\ \ l--
(t r '
11412011
I ezer-1/1 Arrival Time:l(o ~ ov I Departure Time:ljpt! o() I County~f~ Region: ;::t;u
Farm Name:'--Jkrn..:.L..O"""-'-~:v,_~"--o:<;..oLJft::...L...:r:;~M=+-{?r.....=:.(11..:.f.~m::...r..._Fff& ........... ;;2..."-~--
Date of Visit:
Owner Email:
Owner Name: 5Jrz::J Phone:
Mailing Address:
Physical Address: ---:------------------------------------------
___;ck:....;-...=:....;"....!h:...::.!eS:loo:!..........t:.h=r=_s...t= _____ Title: --~L.C:.'-oir;:;;,L,C_____ Phone: 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: 0 Structure 0 Application Field
a. Was the conveyance man-made?
0 Other:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
lnt•gnotor' ~~
Certification Number: ~-...:::::::::.......:4 _____ _
Certification Number:
Longitude:
0 Yes 12}No DNA ONE
0 Yes 0No DNA ONE
0 Yes 0No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
0 Yes
DYes
(a No DNA ONE
f5a No DNA ONE
2/4/2011 Continued
(Facility Number: (Date oflnspection: Z-??7Zbll
Waste Collection & Treatment
' 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard ?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are riot properly addressed and/or managed through a
waste management or closure plan?
0 Yes (2gNo 0 NA 0 NE
0 Yes 0 No 0 NA 0 NE
Structure5 Structure6
DYes ~No 0 NA QNE
0 Yes !:sa No 0 NA 0 NE
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 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 s tructures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
0 Yes J.8lNo 0 NA 0 NE
DYes ~No DNA ONE
D Yes ~No 0 NA 0 NE
ll.ls there evidence of incorrect land application? [fyes, check the appropriate box below. 0 Yes ~o 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 . Crop Type(s): h-~&!... &?-<c-r,.5 J
13 . Soil Type(s):
14 . Do the receiving crops differ from those des ignated in the C A WMP'?
I 5. Does the receiving crop and/or land appli cation site need improvement?
I 6 . Did the facility fail to secure and/or operate per the irrigation des ign or wettable
acres determination?
17. Does the facility lac k adequate acreage fo r land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19 . Did th e facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the faci lity fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
0 WUP Ochecklists 0 Design 0 Maps 0 Lease Agreements
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes ~0 DNA ONE
DYes ~No DNA ONE
0 Yes flLNo DNA ONE
0 Yes JKLNo DNA ONE
0 0ther :
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 NA 0 NE
D Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers 0 Weather Code
D Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey
DYes [8l_No
22 . Did the facility fail to install and maintain a rain gauge? D Yes ~o 0 NA 0 NE
23. If selected , did the facility fail to install an d maintain rainbreakers on irrigation equipment?
Page2of3
0 Yes LEJ No 0 NA 0 NE
21412011 Continued
\
I Facility Number: I nate of Inspection: ?-~@//1
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 [2gNo DNA D NE
DYes i29No DNA ONE
D Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of frrst survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems , over-application)
31 . Do subsurface tile drdins exist at the facility? If yes, check the appropriate box below.
D Application Field D Lagoon/Storage Pond 0 Other:
DYes f29..No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes [61No DNA ONE
0 Yes j3..No DNA ONE
------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
DYes IKJ_No DNA ONE
DYes RNo DNA ONE
DYes
Phone: 27;p--q13-3300
Date: 2~~/
21412011
ompliance Inspection 0 Operation Review 0 Structure Evaluation
Reason for Visit ~ne 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I!JN.7'1f Arrival Time: I /¢; 31)
Farm Name: ?i.t,hu.l :5T?d &~
I Departure Time: b2i0:t> I county~ Region: FJi::.D
~ Owner Email: --------------
Owner Name: -~..c-?n~-;.,;c;s-::..,L"J--------...:~...:;ar.;.;._-n.-=~:;..._-:Z::~--"-".:...:;.t:,;_• ___ _ Phone:
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: C.h<d.s L ~::c. Title: -----------Phone No: ---------
Onsite Representative: ~ ~ J-.1:' "C.... Integrator: ,btP~
/71,-/r.-c_ _..-?:'-'r;:.:........=.:r'""""'r.""'/~------Operator Certification Number: --------Certified Operator:
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Disc harges & Stream Impacts
I_ Is any discharge observed from any part of the operation? D Yes lRNo DNA ONE
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)?
d. Does discharge bypass th e wa ste managem ent 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 th e Waters of the State
other than from a discharge?
Page 1 of 3
D Yes 0 No DNA ONE
D Yes 0No DNA O NE
I
DYes 0No DNA O NE
D Yes ~No DNA O NE
D Yes lia No DNA ONE
11/28104 Continued
j Facility Number: 8J.=-Z:531 Date oflnspection IJ~-,&-1}
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
DYes (2i;;!No 0 NA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:------------------------------------------
Spillway?:
Designed Freeboard (in): _ __t.../_1!.-----------------------------------
Observed Freeboard (in): 6D
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 !2iNo DNA 0 NE
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 stuctures Jack 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 ti?J. No DNA 0 NE
DYes [RNo DNA ONE
DYes !MNo DNA ONE
DYes ~No DNA ONE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes B.No 0 NA D NE
D Excessive Ponding D Hydraulic Overload 0 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 Area
12. Croptype(s) &,~ ~s-rr/1 C!t¥'1 !tv/~/sa~,-1""~/J/-h.vr
T /
13. Soil type(s) --'~(LJ.'L-·----------------------------------
14. Do the receiving crops differ from those designated in theCA WMP? DYes
15. Does the receiving crop and/or land application site need improvement? DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable 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/1 nspector Name
Reviewer/Inspector Signature:
DYes
DYes
Date:
IE No DNA ONE
~No DNA ONE
Eil_No D NA D NE
f.iZJ..No DNA ONE
paNo DNA ONE
Page 2 of 3 12118104 Continued
r •
I Facility Number: Q -b£1 Date of Inspection 1/J?..?-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. 0 WUP D Checklists 0 Design 0 Maps 0 Other
21.
DYes 1:2iNo DNA ONE
DYes U(No DNA D NE
Does record keeping need improvement? If yes, check the appropriate box below.
~te Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers D Annual Certification
0 Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and I" Rain Inspections D Weather Code
~s Go DNA ONE
22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes 0No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~o DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~0 DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes l:RNo DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes l2iNo DNA ONE
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?
DYes ~No DNA ONE
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes j&No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes SNo DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes 2-No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes 12!-No DNA ONE
... ~ t •• ~ .... : • .,.
•' :.. I ~ : ''
Page3of3 12/28/04
f
Type of Visit e-cci"mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: l/ /-JJ:D<f I Arri\·al Time: I/,' 0 0
FarmName: dbnf/Zi ~2
I Departure Time: "j .' 3'0 I County: Region: ffl>
l?um ~ OwnerEmail: ----------------------------
Owner Name: 5 /l:! --c:oJ.. Phone:
Mailing Address: -------------------------------------------------------------------------
Physical Address: -------r----------------------------------------------------------------
Facility Contact: __ d_-r-l2/;___:_~..::~=--"""'LL~:""""":._oL ___ Title: ~~~=-----------Phone No: --------
Onsite Representative: (:lttvh5 ~-~ Integrator: ht.u,~k
Certified Operator: ----~oi:.....LI ______ !_!_________ Operator ~ertific:z:mber: -------
Back-up Operator: ------'----------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes 12?J...No 0 NA D NE
Discharge originated at: D Structure D Application Field D Other
a. Was the conveyance man-made?
b. Did the discharge reach waters ofthe State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
DYes DNo
DYes 0No
d. Does discharge bypass the waste management system? (If yes , notify DWQ) 0 Yes D No
2. Is there evidence of a past.cljs'Ob~tge from any part of the operation? '""~':'. ,:,':0 Yes ~No
....... , • LH
3. Were there any adverse impacts or potential adverse impacts to the Waters ofthe State
other than from a discharge?
DYes ~No
12128104
DNA ONE
DNA ONE
I
DNA ONE
DNA ONE
DNA ONE
Continued
I Facility Number:&:-k5J¢r Date of Inspection 1/1:: Z3-Jf7
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?
0 Yes Df..No DNA 0 N E
DYe s 0No DNA ONE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:---------------------------------------
Spillway?:
Desib'lled Freeboard (in): __ __.Jt'-+2--------------------------------------
Observed Freeboard (in): ___ 'f.:........,j1~.--__ -----------------------------------
5. Are there any immediate threats to the integrity of any ofthe structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes ~No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA O N E
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA O N E
DYes ~No DNA ONE
DYes ~N o DNA O NE
DYes ~No DNA ONE
II. Is there evidence of incorrect application? If yes, 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 0 PAN> 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Croptype(s) ~uJa. /r,J~ brtt /~f-/mtl/e-f; /:R_v~
I (
13. Soiltype(s) U)a.~ /$olf Jlt"-j ~:E
14. Do the receiving crops differ from those designated in theCA WMP? DYes 13No DNA
15. Does the receiving crop and/or land application site need improvement? DYes ~No DNA
ONE
ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? DYes J&l. No 0 NA 0 NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Comments (refer to question#):
. Use drawings of facility to better
Reviewer/Inspector Name
Reviewerllnspector Signature:
DYes [&l_No DNA ONE
DYes ~0 DNA ONE
Date:
.. j Facility Number: ~-?ij Date of Inspection 1/1-13 ~?
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 appropriate box. 0 WUP 0 Checklists D Design 0 Maps D Other
DYes 8-No DNA ONE
DYes l&No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes ~o 0 NA D NE
D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D W~te Transfers D Annual Certification
0 Rainfall D Stocking D Crop Yield D 120 Minute Inspections D Monthly and 1" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~0 DNA ONE
-23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes 13-No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes IE No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes 18No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes g.No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes 18l..No DNA ONE
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?
DYes jg.No DNA ONE
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes 12Wo DNA ONE
If ye s , contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes j&No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32 . Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE
33 . Does facility require a follow-up v isit by same agency? DYes &No DNA ONE
12128/04
..
t
ompliance Inspection 0 Operation Review
Reason for Visit ~tine 0 Com~laint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: I JO~rrival Time: I /!) .'0'{) I Departure Time: I /¢! D '0 I County:~ Region: fflJ
Farm Name: r/z f)mt:f :S j-r;.d Fa_.;-m ~;)-Owner Email: ------------
Owner Name: .S~~J F?u'm) _:[::d t:-. Phone:
Mailing Address:
Facility Contact: Phone No: _________ ___
Onsite Representative: ....... ~I'.Lji'-""'"'---....:;....::;....,-=:.. ________ _ Integrator: IJt a f)' 7
Certified Operator: -~~~~o-~::~o"""'-...L.---__ 5«-...:..f..;;Y,;..:i".<::..::;~-------Operator Certification Number: !"771 0
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 th e operation ? DYes ~o DNA ONE
Discharge originated at: D Structure 0 Application Field D Other
a. Was the conv eyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons )?
d. Does discharge bypass the waste manage ment system? (If ye s, notifY DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any advers e impac ts or potential a dve rse impacts to the Waters of the S tate
oth er than f rom a discharge?
Pa g e I of 3
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes 0.No DNA ONE
DYes l)a.No DNA ONE
12128/04 Continued
.
' I Facility Number: f1?. -~531 Date of Inspection
Waste Collection & Treatment
' 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? DYes ~No DNA ONE
a. If yes, is waste level into the structural freeboard? 0 Yes 0 No 0 NA 0 NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:------------------------------------------
Spillway?:
Designed Freeboard (in): /1'
Observed Freeboard (in): 5]
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
0 Yes ria' No 0 NA D NE
6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered )'es, 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 af"No DNA ONE
0 Yes 18JNo DNA ONE
D Yes [i No DNA D NE
DYes l:itNo DNA ONE
II. Is there evidence ofincorrcct application? If yes, check the appropriate box below. 0 Yes ®No 0 NA D NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
12. Cmp typ<(s) leon,).._ lvwa&J fre..,.., /u)..j-¥--/ttr&tiye
13. Soil typc(s) lJlcv i3 / po 13 / 1/:u ./ ftu. JI
14. Do the receiving crops differ from those desib'llated in theCA WMP? DYes Jkj No DNA ONE
15. Does the receiving crop and/or land application site need improvement? DYes 00 No DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination? DYes ~No 0 NA D NE
17. Does the facility lack adequate acreage for land application? DYes ~No DNA ONE
18. Is there a lack of properly operating waste application equipment? DYes ~No DNA ONE
Page2of3 12128/04 Continued
I
I Facility Number:~ -t:6J I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. O WUP 0 Checklists 0 Design 0 Maps 0 Other
21. Does record keeping need improvement? Ifyes, check the appropriate box below.
DYes rnNo DNA ONE
DYes &:JNo DNA ONE
DYes ~No DNA ONE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes f;81No DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes IKJ.No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes [BNo DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes lS'iNo DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes l&l.No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
DYes ~No DNA ONE
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes [RNo DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
12{No 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes DNA ONE
33. Does facility require a follow-up visit by same agency? DYes !ZNo DNA ONE
In ~ 11'~ .. --;..-• -'
~~~·~· : ~' .. .,\;.,.:. .
Page3 of 3 12128/04
.!
I
'
./
I Facility Number I fffl __ H t~/i} II Q'Division of W a ter Quality
0 Division of Soil and Water Conservation
0 Other Agency
~tfji""' I v~
Type of Visit @"CCmplla ce Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: IIO~P?I Arrival Time: I L/,' t>O I Departure Time : I J :DO I County :--¥~ Region: IS? D
Farm Name: ~"" j l 5~ Cat"h"-r Owner Email: ------------
Owner Na meS7?r:.J fi~nt.3 -z:;;, e... Phone:
Ma iling Address: ----------------------------------------
Physic al Address:----------------------------------------
Facility Contact: ....,/!~h~,.~~•-.J(:._.t ..... ~..,~-....::/..:;....;;..oC........:;r= _____ Title: -----------PhoneNo: __________ _
Onsite R epresentative: -fi:;....::~~;:::;;..... _____________ _
C ertified Operator: dfln?~ In .cred
Integrator: /!1H~
Operator C ertification Number: -------
Back-up Operator : --------------------Back-up Certification Number: . -------
Loca tion of Farm: Latitude: D OD 'D " Longitude: D OD 'D "
Design Current Design Current Design Curre n t
Swine Capacity P opula tion Wet Poultry Capacity Population C attle C apacity Popula tion
ID Wean to Finish I I 10 Laye r
0 Wean to Feeder :
Jil Feeder to Finis h :J(p2~ 3~
0 Farro w to Wean '
0 Farrow to Feeder
I
0 Farrow to Finish :
0 Gil ts I
0 Boars .. ·-. -·-·-. . -
P Non -Laye l I I I O DairyCow I
I
D Dairy Calf I D Dairy He ife1 .
ODrvCow
I
0
0
0 N on-Dairy I
D Bee f Stoc ke r
D BeefFeeder I
' D Beef Brood Cow I --. --·-
Dry Poultry
0 La ye rs
0 Non-Layers
0 Pull ets I
I
0 Turkeys
--. ___! .
0 Turkey Poults
0 Oth er
----
Number of Structures: u:] Otber
D isc h a rges & Stream Impacts
1. Is any discharge observe d from any part of the operati on? 0 Yes 18-N'o 0 NA 0 NE
Discharge orig inated at: 0 Structure 0 Appl icati on Field D Ot her
a. Was the conveyance man-made? D Yes D No DNA O NE
b . Did the disc harge reac h waters o f th c Sta te ? (I f yes, notifY DWQ) DYes D No DNA ONE
c . What is the est imated volume th at reached waters of the Stat e (ga ll on s)? I
d. Does discharge bypass the waste management sys tem? (I f yes, noti fY DWQ)
2 . Is there ev idence of a past discharge from a ny part of th e operation?
3 . Were the re any adv erse impac ts or potential advers e imp acts to th e Wa te rs of the State
oth er than from a di scharge?
D Yes 0No
D Yes 3 No
D Yes 3.-No
12128/04
D NA O NE
D NA ONE
D NA O NE
Contin ued
[Facility Number&J: -l63l Date of Inspection IIP-11-:i'~ ,
Waste Collection & Treatment
4. Is storage capacity {structural plus storm storage plus heavy rainfall) Jess than adequate?
a. If yes , is waste level into the structural freeboard?
Structure l Structure 2 Structure 3 Structure 4
DYes SNo DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:---------------------------------------
Spillway?: ---------------------------------------
Designed Freeboard (in): / 'f'
Observed Freeboard (in): ,'f:(,
5. Are there any immediate threats to the integrity of any ofthe structures observed?
(ie/ large trees, severe erosion, seepa ge, etc.)
6. Are there structures on-site which arc not properly addressed and/or managed
through a waste management or closure plan?
DYes £&\No DNA ONE
0 Yes 18 No DNA ONE
If any of questions 4-6 were answered yes, and tbe situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenan ce or improvement?
8 . Do any of the stucturcs Jack adequate markers as required by the pennit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setback s , or compliance alternatives that rieed
maintenance/i mprovement?
DYes ~No DNA ONE
DYes 18No DNA ONE
DYes 3-No DNA ONE
DYes !&No DNA D NE
II. Is there evidence of incorrect application? lfyes, check the appropriate box below. 0 Yes 00-.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
D Outside of Acceptable Crop Window D Evidence of Wind Drifl D Applicotion Outside of Areo h
:: ::P;;::> ~HL~-. /wf...l./tur!l~c
14. Do the receiving crops differ from those designated in theCA WMP ?
15 . Does th e receiving crop and/or la nd application site need improvement?
DYes
DYes
I 6 . Did the facility fail to secure and/or operate per the irrigation de sign or wettable acre detennination?O Yes
17 . Does the facility Jack adequate acreage for land application?
I 8. Is there a lack of properly operating waste application equipment?
DYes
DYes
[!No
lBJ No
,S.No
fKI No
6'\No
Comments (refer to question#): E1:plain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
DNA
DNA
DNA
DNA
D NA
ONE
O NE
ONE
ONE
ONE
....
1-
~ ....
Reviewer/Inspector Name <'~ . ~~~~ Phone: ?-/P-¥J:J -_3_sr>c
Reviewer/Inspector Si gnature: --"!? 1 Jt'f , /J'J-/'-~7 ~ /-'-.. Date: ... /2128104 Co ntrnued
f
i
i. • I Facility Number: ?)L-kfJJ Date of Inspection 1/P"' 11it7
Required Records & Documents
19 . Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to ha ve all components of theCA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Des ign 0 Maps 0 Other
CJYes ~No DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No 0 NA D NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections D Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fai l to install and maintain a rain gauge ? DYes QiNo DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes .,S.No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE
25. Did the facility fail to conduct a sludge survey as required b y the permit? DYes SNo DNA ONE
26 . Did the facility fail to have an acti vely certified operator in charge? DYes ~No DNA ONE
27. Did the facility fa il to secure a phosphorus Joss assessment (PLAT) certification? DYes ~No DNA ONE
Other Issues
28. Were any additional problems noted which ca us e non -compliance of the permit orCA WMP? DYes JKlNo DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes SNo 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 SNo DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes 18No DNA ONE
General Permit? (ie/ discharge, freeboard problems , over application)
32. Did Reviewer/Inspector fail to discuss review/i nsp ection wi th an on-site representative? DYes .ml_No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes .KJNo DNA ONE
Additional Comments and/or Drawings:
.... -
f-...
11118104
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~ine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: 1/p-3--'l)(Q I Arrival Timed o~30 I Departure Time: 1//: oo I County:~
FarmName: 5~d ~t:ltl"rn$ 5r?c, liF;;L_ OwnerEmail: ------------
Region: CJ<:()
OwnerName: STz-eJ Fa.rm_j ..;F=r1~. Phone:
Mailing Address: -----------------------------------------
Physical Address:------------------------------------____ _
Facility Contact: ~c-..LA.u4;:.:"":......~~:L:4~~<-....c.l-.e...=;...~."::;;;,_----Title: __________ _ PboneNo: ________ _
Onsite Representative: __ --L;ld~'J._~__,;_:......:.. ___________ _ Integrator: /!11.1~
Certified Operator: ----~_5;"""""14s.:v=:w:....--------------
Back-up Operator: --------------------
Operator Certification Number: ICe 2/?..
Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude: D OD'D"
Current
Wet Poultry Population
Dry Poultry
D Layers
D Non-Layers
D Pullets I
I
D Turkeys ~
D Turkey Poults I
D Other -~ -----
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes t8J.No DNA ONE
Discharge originated at: D Structure 0 Application Field D Other
a. Was the conveyance man-made? DYes 1:81 No DNA ONE
b. Did the discharge reach waters ofthe State? (If yes, notify DWQ) DYes ~No DNA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notifY DWQ) DYes 1:81No DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of3
DYes JBINo
DYes ~No
12128104
DNA ONE
DNA ONE
Continued
·'· I
I Facility Number:Q-.-/,QI Date of 1 nspection I /o=: 3-oij
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 Structure4
DYes !RNo 0 NA ONE
DYes !&.No DNA ONE
Structure 5 Structure 6
Identifier:----------------------------------------
Spillway?:
Designed Freeboard (in): -~1;,...._.:1 ___ ------------------------------
Observed Freeboard (in): ---'Si=-'t{_._ ___ ------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes ~No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes ~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 ofthe 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 ~No DNA ONE
0 Yes (Sa 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. 0 Yes !Ja.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 Area
14. Do the receiving crops differ from those designated in theCA WMP? DYes ~No DNA
15. Does the receiving crop and/or land application site need improvement? DYes jg~No DNA
\
ONE
ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes ~No0NA0NE
17. Does the facility lack adequate acreage for land application? DYes BJ,.No DNA ONE
18. Is there a lack of properly operating waste application equipment? DYes 1iJ No DNA ONE
Cofulll~~~~:{'refer to question;#): Explain any YES answers and/or ny;_r~tmll[l~i~Q~altlOJ:ls or any other cmnlllie
se dra~ihgs offacility to i;(!rter explain situations. (use additional P8ll'!es~:as",necessar-y):
. . -~-~· .-:'} . .--.. -. . .. . .
Reviewer/Inspector Name :...._ __ _,_J-.!::::::...!:-~.--~~....:;t.U:....::.--------'"-----·1 Phone:
Reviewer/Inspector Signature: Date:
9(o-#33-33oo
/12=. 3 <:?l> D fo
Page2of3 /2/28/04 Continued
I Facility Nu~ber: tf2 -t5j Date oflnspection I I0-3 -pfo
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. O WUP D Checklists D Des ign 0 Maps D Other
DYes Ai:lNo D NA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? If yes, chec k the appropriate box below. 0 Yes ~No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification
D Rainfall 0 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?
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 ass essment (PLAT) certification?
Other Issues
28 . Were any additional problems noted which cause non-complian ce 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 fa cility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediate ly
31 . Did the facility fail to notify the regional office of emergency situa tions as requ ired by
General Permit? (ie/ discharge, freeboard proble ms, 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 Comme~~~arid/orDrawings:
Page3 of3
DYes 5No DNA ONE
DYes El.No DNA ONE
DYes ogNo DNA ONE
DYes !BINo DNA ONE
DYes [iaNo DNA ONE
DYes jiZl No DNA ONE
DYes ~No DNA ONE
DYes .RJ.No DNA ONE
DYes ~No DNA ONE
DYes ~No .DNA ONE
DYes IX]_ No DNA ONE
DYes .Ill-No DNA ONE
··.y;::,·:·~t·~
....
i-
-.....
12128104
(iJ~Jacility~~-~~~~~ 82 H tr3 !J
i,l~ ':_ ; __ ; .-:;_:-'"'' ~-;::~:,:·: ... --~: -::..~.:~-:-~::.: ., ~
• Division of Water Quality
0 Division of Soil and Water Conservation
0 Oth~r Agency. ,
Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I ?·.?/·Dr' I Arrival Time: Ll ___ ___.l Departure Time: ._l ___ ___.l Count}·: ~¥$;=1:1'--"'----Region: ~0
Farm Name: Owner Email: --------------
OwnerName: ______ ~..$:...:.:1~"-'J_ Far,.y 1 ;r,.,, _____ Phone: .!iJ.P-.G.'!-4.5:/.(.!!:.1.!!!..--_____ _
Mailing Address: :2311 lt.t:tt~r ~oa.f. _______ -~la..a AIL
Physical Address:-----------------------------------------
Facility Contact: CJ..,./r.r Le~ Title: -----------Phone No: ....:iLo-~it -'tc.l~­
lntegrator: l'flhJ'Y-FA~-+ Ft!t.:..::'..!!~=4-J---Onsite Representative: ____ ...,!:a~,.,_,~/~~J, ___ ....;;'l;;;...:.~..::l!!:::.._ ____ _
Certified Operator: KJ,'/tc .fb,.e.f Operatur Certification Number: l.'}'•u_ ... o,__ __ _
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
ID Wean to Finish I I ~~~=.~~~:~;~~~~-ay_e_r--+1-------+------~1 D Wean to F ceder
fGf'Feeder to Finish 3(,'7;}..
D Dairy Cow
D Dairy Calf
D Dai_ry Heife1
D Farrow to Wean
D Farrow to Feeder
D Farrow to Finish
D Gilts
D Boars
' . --
Dry Poultry D DrvCow
D Non-Dairy
D BeefStocker
D Beef Feeder
D Beef Brood Co\\
··-· ---
D Layers
D Non-Layers
D Pullets
D Turkeys
Other D Turkey Poults
D Other Number of Structures: D ID Other I
Discharges & Stream Impacts
I. Is any discharge observed from any pan of the operation? DYes ~o DNA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other
a. Was the conveyance man-made? DYes 0No DNA ONE
b. Did the discharge reach waters ofthe State'' (If y es , notify DWQ) DYes 0No DNA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes. notify DWQ)
2. Is there evidence of a past discharge from any part ofthc operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
DYes 0No
DYes GtNo
DYes !&'No
12128/04
DNA ONE
DNA ONE
DNA ONE
Continued
I Facility Number: /D. -{,£j Date of Inspection I ? -~.7·~:~,. l
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes ~DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:-.......:.--'--------------------------------------
Spillway?; no ,,
Designed Freeboard (in); __ .:...1-~.2'.......:. ___ ----'---------------------------------
Observed Freeboard (in); __ _,'1'-(,=--_'_' __ ----------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes ~0 DNA ONE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed DYes ~ DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental tbreat, 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 requ ire
maintenance or improvement?
Waste Application
1 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes 8'N'o 0 NA 0 NE
DYes O'No DNA ONE
DYes ~o DNA ONE
DYes EJ1io DNA ONE
II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~o 0 NA D NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 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 D Appli cation Outside of Area
/-J fV I, ~ 7 ;7'1) l-:> ~ Ofet
12. Crop type(s) <!2JNrruJ <z; ts;sc /Je 0 ,",J, -1/p.T A.,.O.. .,{-. -~ca1d
13. Soil type(s) ,
14. Do the receiving crops differ from those designated in theCA WMP?
I 5. Does the receiving crop and/or land application site need improvement?
DYes G?'No DNA
DYes ~o DNA
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination! 0 Yes D No D NA
17. Does the facility Jack adequate acreage for land application? DYes 0No DNA
ONE
ONE
[J-lqE
~
18. Is there a lack of properly operating waste application equipment? DYes ~ DNA ONE
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone: '1 !rJ= 't'llrkCf/ ,..,f?lO
Date: '7 -.J,;)-t? C
11118/04 Continued
4 "' ....
I Facility Number: 8:l -~f"l Date of Inspection 7 ·.J.14f"
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 . 0 ¢" D c~ D D~ D ~ D ~
21. Does record keeping need improvement? If yes , check the appropriate box below.
DYes ~ D NA ONE
DYes ~DNA ONE
~s 0No DNA ONE
~3te Application D Wi!i!lil:J Free"e8fd D Wti:ste Analysis 0 Seil Analysis 0 We!ite Ttansfers 0 Aanual Cettificatie9-
D ~I D ~ 0 Crop Yie)Q D ~e Minute Inspections D Mettt:ldy and I Ram lnspcettefis O.weachet Cooe
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 faci li ty fail to calibrate waste application equipment ~~quired 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 o f 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 represen tative?
33. Does facility require a follow-up visit by same agency?
;;l/,
4s
·.S
.,..e, ,,...._
fi.~ ~R-.2
..sl. #,., .,/ tt1'1. 1 .!J/J,..,)
-/;,,., I
t:;rves 0No DNA ONE
DYes GJ.No" DNA ONE
D Yes l:d'No DNA ONE
D Yes ~0 DNA ONE
DYes !&No DNA ONE
D Yes 0No DNA g.,qE
DYes 91Cfo DNA ONE
DYes G:f"No DNA ONE
DYes ~ DNA ONE
DYes E2f'No DNA ONE
DYes 0No DNA ONE
D Yes 0No DNA O NE
ll/18/04
(I" Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 8 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other D Denied Access
Facility Number 1 id H ~r~ IDateofVisit: I ~-~·oY hime: I 1;61Jp..l
"----------------------'-IO Not Operational 0 Below Threshold
&::~-Permitted [] Certified C Conditionally Certified C Registered Date Last Operated or Above Threshold: ···--·-----··
Farm Name: .......... ~'f.r.r.J... ......... E.~.~S. ....... "!!:..?.:................................................. County: --~~':¥'..f.g~---···-·----·-·-.. fJt...Q. ...... .
Owner Name: ..... £ ..... ~.£?..\a:s::. ........ $./~.e.t:L ... Lt;v..l!!:l.J.y.~---····· Phone No: ___ 9/_0. S"&.~-~[.;_ ________ _
Mailing Address: .. -~ .. 1./J. ........... f.(r.t!.~.~.c ............. R..(l&uL_ _____________ {_~-~~!l.~-r-·ff...(__ ____________ .2.8..)_~.1l..... ---·------···
Facility Contact: ··-·-·---~_6.4!:./r..J.. ............. f.~t;,_--·----Title: --·---····-·············-·-·-···-··-···-·-· Phone No: -------·-------··
Onsite Representative: ........ ?.:!.J.edt.J. ................. ?:...!:.L ... ______________ Integrator: ... .L!' v !12-¥.--------·-----------
Certi.fied Operator: ............... r:;.f.t.,ul~t.............. . ....... !.r...!..{....r-·-·--····--·-·-····-··· Operator Certification Number: -···-··--··---····-·--·-····
Loca • fF ~ '' '"' Nl.'/4.. ~h•rA tion o ann:
EJ<wine D Poultry D Cattle D Horse Latitude
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Lagoon 0 Spray Field D Other
a. If discharge is observed, w~ the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c . If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2 . Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? D Spillway
Structure 1 SU1lcture 2 Structure 3 Structure 4 Structure 5
Identifier: -·······----.1. .............. .
Freeboard (inches): __ L.J..L.J~U-~~----------------
12fl2m3 --------
DYes [Y.NO
DYes ~
DYes GI-No ---DYes [].Nr>
DYes GI-NO
DYes [3-No
DYes GJ-H'o
Structure 6
Continued
JFacility Number: ~ '::2 -4: n .I Date of Inspection I 1-21---u'-1 I
5. Aie there any iriunediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
seepage, etc.)
6. Aie there structmes on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(H any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancefunprovement?
8. Does any part of the waste management system other than waste structures require maintenancefunprovement?
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 0 PAN 0 Hydraulic Overload 0 Frozen Ground D Copper and/or Zinc
12. Crop type ~~lhvJe.fJt:J 5,...el/ 6-t--a.(l
13. Do the receiktg crops diffe; with those designated in the Certified Animal Waste Management Plan (CA WMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hom?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
Reviewer/lospector Name
Reviewerllnspect.or Signature:
12112103
DYes B'No
DYes [3'No
DYes [3Nc;
DYes [d'No
DYes ~
DYes ~
DYes 9-NO
DYes @NO
DYes DNo
DYes 0No
DYes DNo
DYes 13'No
DYes [9'NO
DYes DNo
DYes [3-No
DYes 9-NO
DYes [3-NO
[Facility Number: )..2 -&on J Date of Inspectjon I ~ ?!fl'll
Reauired 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~~~~tc.)
23. Does record keeping need improvement? Hyes, check the appropriate box below.
D Waste Appli;a1iOR D nuboud D Wasto ,A n'm D SeH Sampling •
R·JO-) :J.·'f-J. 0 ' ·:JI -O'f-9 I. 1 J ~ d tt-/if -J ?. '7, J. >
24. Is Iacility not m cofnpliance with any applicable set6ack 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 siwations as required by General Permit?
(ieJ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss reviewfmspection with on-site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified A WMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected. did the facility fail to install and maintain rainbreakers on iirigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
0 ~JaRs Fmm ~ 0 Crap Yietd Fotru 0 binfal1 Cl Inspection Afret I RaiD
D 129Mi:nntelnspeetions 0 Aminal Cenifiguion..Pentl
# 33 t:t.,cJ 3 '1
12112/03
DYes ~
DYes ~
DYes ~
DYes 1:3-NC
DYes [3-NO
DYes ~
DYes G-KO
DYes 16}No
DYes 1:3-N<>
~ONo
DYes [;}NO
DYes 9-No
DYes [iJ.Nf)
DYes GJ.Ntr
DYes 9N~-
Site Requila Immedate AUcntion : N D
Fldlity No. t.lrt k.~\s..«w
DMSION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERA nONS SITE VISIT A DON REC0JU>
DATE: \o fwsui • 1995 j
Time: \2:~0
Pbonc: \-~DO -ZJ6-l..ll '\
Phone: '\lo-SC..4-Co"\13
•
Type of Opention: Swine X PouJtJy _ Cattle------------
Desip eap.city: ~ "12.. Number of Animals on Site: -----~;::.;b"'-:1=Z.=----------
DEM Certification Number: ACE..___ DEM Certification Number. ACNEW _____ _
Latitude :_._.-· Longitude :_._._.
Circle Yes or No
Does the Animal Waste Lagoon ~ sufficient freeboard of I Foot + 25 year 24 hour storm event
(appro~mately J Foot + 7 inches) ~ No ~ Freeboard: f.s. Ft. _£_Inches ·
Was ay seepa&e observed from the ~(s)? Yes ofJ!p Was any erosion observed? Yes or~
Is adequate land available for spray? Y or No Is the cover crop adequate? Yes~,
Crop(s) bein& utilized: 7o AC~~e5 ~~h.'ok. \ \1ou.RW~L t.lo ~o\J~<.. Cllo£ ~~\15\,.,L yd:
Does the fAcility meet SCS minimum setback criteria1 200 Feet from DweJlin~ @or No
JOO Feet from Wells? ~or~
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream'? Yes or~
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes ~
15 animal waste discharged into water~ state by man-made ditch, flushing system, or other
similar man-made devices? Yes OJ\l!9) If Yes, Please &plain.
Does 1M facility maintain adequate waste manaaement records (V9hlmes of manure, land applied,
spray irri&ated on specific acreqe with cover crop)'? Yes or~
Additional Comments: klfw f~ --rFi= wt.S (Us 9 pWttJ_t.L, :\b\"1:: b)2") £ 1\hAM, \)g~~ \-'> b:~ fut..o!>~ 0Y'C~, 'r\ £-\'6~d., t..~~\¥~'6 1 ui\~tt, ·
Jnspecaor Name
·a:: Facility Assessment Unit Use Attachments if Needed.