820655_INSPECTIONS_20171231

NORTH CAROLINA
Deparbnent of Environmental Quality
Compliance Inspection
Reason for Visit: e Routine 0 Complaint 0 Other 0 Denied Access
Date ofVisit:l "(2:z{'fl Arriva1Time :l11 ~3~1 DepartureTime:I/Z;oop""l County: ~h Region :~
Farm Name: J?'~ (A~ ~I'=' Owner Email:
I I
Owner Name: '{?.ch,___J (4 s::e;, Phone:
Mailing Address:
Physical Address:
Facility Contact: J2l2:;7 Vi~
O .R . "-' ostte epresentative:
--------~~-----------------------------
CerQfied Operator: gh-.z{ G ~
Title: Phone:
Integrator: tfirhl~e~r:
Certification Number: r/J' 2. '2-
Back-up Operator: C ertification Number :
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure 0 Application Field 0 Other:
D Yes ~No D NA O NE
a. Was the conveyance man-made? 0 Yes 0 No (!] NA O NE
b. Di d th e discharge reach waters of th e State? (If yes, notify DWR) 0 Yes 0 No ~NA O NE
c. What is th e estimated volume that reached waters of th e State (gallons)?
d . Does the discharge bypass the waste ma nagement system? (If yes , not ify DWR) 0 Yes 0No ~NA O NE
2. Is there evidence of a past discharge from any part of the operat ion?
3. Were there any observable adverse impacts or potential adverse imp acts to the waters
of the State other than from a discharge?
Page I of3
0 Yes ~No
0 Yes No
DNA ONE
DNA ONE
214/2015 Continued
IFacilityNumber: ®;-65"5~ ...
Waste Collection & Treatment
loate of Inspection: 12/zf! K
4. Is storage capacity {structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure2 Structure3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): .38 11
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 ~NA ONE
Structure 5 Structure 6
DYes fNo DNA ONE
DYes I? No DNA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public heaith or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures 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
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
0 Yes ~No DNA ONE
11. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. 0 Yes ~No DNA D NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etd
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure /Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area
12.Crop Type(s): C't)q_sk{ kJ_q k;; Okry), §Go
13. Soil Type(s): ----.fVf----..;...c..L.k.._ _______________________________ _
14. Do the receiving crops differ from those designated in the CA WMP?
15. Does the rec e iving 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 eq uipment ?
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 D Design D Maps D Lease Agreements
0 Yes No DNA ONE
0 Yes No DNA ONE
0 Yes No DNA ONE
0 Yes ~No DNA ONE
0 Yes ~No DNA ONE
0 Yes ltJ No DNA ONE
0 Yes Ef No DNA ONE
00ther:
21 . Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~ No 0 NA 0 NE
0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0Stocking 0 Crop Yield 0120 Minute Inspections 0 Monthly and 1" Rainfall Inspections 0 Sludge Survey
22 . Did the facility fail to in sta ll and maintain a rain gauge? 0 Yes ~ No 0 N~ D NE
2 3. If se lected, did the facility fail to insta ll and maintain rainbreakers on irri gation equipment? 0 Yes ~ No 0 NA 0 NE
Page2of3 214/2015 Continued
I Facility Number: ~ ?,-075,... I Date of Inspection: ~ /2-7/ ( (
. ~ , ~No
~No
~4. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes 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.
D Yes
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 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Re viewer/Inspector Signature:
Page 3 of3
0 Ye s
0 Yes
DYes
ENo
~No
~No
DNA ONE
DNA ONE
DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
D Yes ~ No D NA 0 NE
Phone: j(O'-tfJl-1~
Date: fa{?-1/{ 8'
11412015
Operation Review Structure Evaluation Technical Assistance
Reason for Vis it: 0 FoUow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: r3/i1aJ Arrival Time: I tft &i')~ I Departure Time: II 0 ;~I County: 5~ Region: fl2o
FarmName: Pt~ Ca~ ~ Owner Email:
Owner Name: ~ 1ci.o.-J G ~ Phone:
Mailing Address:
Physical Address:
Facility Contact: i)o tJ JJ,~o~
lA ~
Onsite Representative: -
Title: Phone:
Integrator:
Certified Operator: (iZ-'C{J----.--G.--~------------
Certification Number: -4/~7.j..:t.g~2.-:....'2-_____ _
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any d ischarg e o bserved from any part of the op erati o n?
Disc harge orig in ated at: 0 Structure 0 A pplicat io n Field
a . Was the conveyan ce man-made ?
D Other :
b. Did the d ischarge reach waters ofthe Sta te? (If ye s, noti fY DWR)
c. What is th e estimated volume that reac hed waters o f the State (gallons)?
Certification Number:
Longitude:
D Yes ~No
0 Yes 0No
0 Yes 0 No
d. Does the d ischa rge bypass the was te mana gement system? (If ye s, notify DWR ) DYes 0No
2. Is there e vid ence of a past discharge from any part of the o perati on?
3. Were there any o bservable adve rs e impacts or po t en tial adverse impac ts to the waters
of th e State othe r tha n fro m a di sc harge?
Page 1 of 3
D Yes ~N o
0 Yes l,iQJ No
DNA ONE
r;s NA ONE
~NA ONE
JZ'NA ONE
DNA ONE
DNA ONE
21412015 Continued
IF~cility Number: !Date of Inspection: t/lln
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure4
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
0 Yes 0 No (29 NA 0 NE
Structure 5 Structure6
DYes ~No DNA ONE
0 Yes EfJ No 0 NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat. notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes
DYes
DYes
DYes
ij] No DNA ONE
l¥No DNA ONE
JS} No DNA ONE
cy1 No DNA ONE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes [$!1 No 0 NA 0 NE
D Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Ou~ide of Aooep~bl~ Cmp Window D E'idenoe of Wind Drift D Appl=:" of Approved A<ea
12.cropType(s): COas-IJ ~~~ ~s {/~) ~s~. kO~
13. Soil Type(s): Nenfe I It: ~o4 '
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box.
DYes [f1 No DNA .ONE
DYes ~No DNA ONE
DYes lfJ No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes [8 No DNA ONE
OwuP 0Checklists 0 Design 0 Maps 0 Lease Agreements Oother: _________ _
21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes ~ No 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 I" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes Q9 No 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? 0 Ye s ~ No 0 NA 0 NE
Page1of3 114/2011 Continued
I
I nate oflnspection: 1ai[P1 I I Facility N.Jimber:
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? Ifyes, check
the appropriate box(es) below.
DYes
DYes
J3.No
~No
DNA ONE
·DNA ONE
D Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
lfyes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notifY the Regional Office of emergency situations as required by the
permit? (i.e ., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Application Field D Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
0 Yes rtJ No DNA 0 NE
0 Yes [5J No 0 NA 0 N E
0 Yes l;tJ No 0 NA 0 N E
D Yes ~ No 0 NA 0 NE
0 Yes ~ No 0 NA 0 NE
0 Y es ~ No 0 NA D NE
0 Yes [B No 0 NA 0 NE
0 Yes IE] No DNA ONE
0 Yes ~N o 0 NA 0 NE
Phone: Cftp-i'$T--7~00
Date : -t!J//1
2/412015
Compliance Inspection
Reason for Visit: e Routine 0 Complaint
Technical Assistance
0 Other 0 Denied Access
Date of Visit: rcrJn;lr;::--1 Arrival Time:l 0/.'oOe I Departure Time: I Ot.,:~l County: ~s(h/ Region: ~ ~ ,
Farm Name: tz;fd o-vJ G.?~ @z=r1A Owner Email:
Owne. Name' 1;•~ ,..__J [k~ Phone'
Mailing Address:
Physical Address:
Facility Contact: Qot~ N~ Title:
Onsite Representative: lit -----------------------------------
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: D Structure 0 Application Field
a . Was the conveyance man-made?
0 Other:
b. Did the di sc harge reach waters of the State? (If yes , notify DWR)
c. What is the estimated vo lume that reached waters of the State (gallons)?
Phone:
Integrator: 5Jk-> 'f{ft.e/d
Certification Number: / 7~'2-1_.,
Certification Number:
Longitude:
DYes ~No DNA ONE
0 Yes 0No ~NA ONE
DYes 0No f¥1 NA ONE
d . Does the discharge bypass the waste management system? (If yes , notifY DWR) DYes 0No ~NA ONE
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a di sc harge ?
Page 1 of3
0 Yes
DYes
~No DNA ONE
fill No DNA ONE
21412 015 Continued
]Facility Number: !Date of Inspection:
\faste 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 Structure 4
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No
DYes 0No
DNA ONE
~NA ONE
Structure 5 Structure 6
DYes
DYes
~No
r5f No
DNA ONE
DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
DYes ~No DNA ONE
D Yes rSJ No 0 NA 0 NE
0 Yes rn No 0 NA D NE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes &J No 0 NA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Eviden e of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in 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?
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 Dchecklists D Design D Maps D Lease Agreements
DYes ~No DNA
DYes ~No DNA
DYes [!]No DNA
DYes l1J No DNA
DYes '¥1 No DNA
DYes ~No DNA
DYes ~No DNA
Dother:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
21. Does record keeping need improvement? lfyes, check the appropriate box below. 0 Yes l$ll No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes $ No 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~ No 0 NA 0 NE
Page 2 ofJ 214/2015 Continued
I Facility Number: <j2:=-QP'" loate oflnspection: 1&/( {,
f I
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes ~No
DYes ~No
DNA Ol\---
DNA ONE
D Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure( s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notifY the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit or 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 :
Page 3 of3
DYes ~No DNA ONE
0 Yes ~ No D NA D NE
0 Yes ~ No D NA 0 NE
DYes ~No DNA ONE
0 Yes tiJ No D NA 0 NE
0 Yes ~No 0 NA 0 NE
0 Yes ~ No 0 NA 0 NE
D Yes [29 No D NA 0 NE
0 Ye s ~ No 0 NA 0 NE
Phone :
Date:
214/2015
Reason for Visit:
Operation Review 0 Structure Evaluation
0 Follow-up 0 Referral 0 Emergency 0 Denied Access
Date of Visit: Departure Time: I oz~l County~egion,P'<i'ZQ
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: --::::::==::-----;------;-----------------------------
<(l.-1ky d·~ Title:---------Phone: Facility Contact:
Onsite Representative: '( lnt<gnotor: ,~
%~ ~ CertificationNumber: ugzz_ Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure 0 Application Field
a . Was the conveyance man-made?
D Other:
b. Did the disc harge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
Certification Number:
Longitude:
DYes ~No
DYes 0No
DYes 0No
d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No
2. Is th ere evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potenti al adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes ~No
DYes !ENo
DNA ONE
~NA ONE
~NA ONE.
!29 NA ONE
DNA ONE
DNA ONE
2/412014 Continued
jFacilitx Number: I Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
r 1
Struc;:r 1 Structure 2 Structure3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes 1?J No
DYes 0No
DNA ONE
~NA ONE
Structure 5 Structure6
DYes ~No DNA ONE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes
DYes
DYes
DYes
;No DNA ONE
No DNA ONE
~No DNA ONE
~No DNA ONE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~No D NA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 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
D Outside of Acceptable Cop Window DJAppl:::~i~n;;tsid: of A~proved Area
12. Crop Type(s): r,. -~~ (JJ
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Oocuments
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box.
0WUP Ochecklists 0 Design D Maps D Lease Agreements
DYes ~No DNA
DYes ~No DNA
DYes No DNA
DYes ~No DNA
DYes ipNo DNA
DYes ~No DNA
DYes ~No DNA
00ther:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No DNA 0 NE
D Waste Application 0 Weekly Freeboard D Waste Analysis D 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 D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? D Yes QSJ No 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? D Yes ffiJ No D NA 0 NE
Page 2 of3 21412014 Continued
~ / ~~ < lfacilityNumber: i"J -i} $"5 I I Date oflnspection: ~ (?
24. Did the facility fail to calibrate waste application equipment as required by the penni; 0 Yes ~ No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes· ~No
the appropriate box(es) below.
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure( s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notifY the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
DYes
DYes
DYes
DYes
DYes
DYes 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes
33. Did the 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?
Re viewer/Inspector Name:
Reviewerllnspector Signature :
Page 3 of3
;No
No
~No
~No
~No
~No
~No
No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
11411014
Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: • Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I 1{ q/'{[ Arrival Timed 0) . .'',.()0 f""' r Departure Time:loz. ~1DfM. I County: ~ Region: {CfiO
FarmName: <:J?~ Qs:e1 .._ TJ)M lOt/ OwnerEmail:
r •
OwnerName: Ptc.-~o/ CJt~ Phone: -------------------
Mailing Address:
Physical Address: -------------------------------------------
Facility Contact: Phone: ___;(j)_~=:J~___;,A}.;;...._:__::~=~c •~vi~ __ Title: --------
Onsite Representative: lA Integrator: ___ M __ .£, _________ _
Certified Operator: 1--'~C..~
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure 0 Application Field
a. Was the conveyance man-made?
D 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)?
Certification Number:
Certification Number:
Longitude:
DYes rpNo
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 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
~NA ONE
f$j NA ONE
~NA ONE
DNA ONE
DNA ONE
2/411011 Continued
.•
(
lii'acility Number: [Date of Inspedion:
I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure3 Structure4
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No
DYes 0No
DNA ONE
~NA ONE
StructureS Structure 6
DYes ~No DNA ONE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes q9 No DNA ONE
II. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. DYes "f:m No DNA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
I2.CmpTypo(•l' ('O<t~-'J.~~ ~ss([{4;); ~-~·~ 0~ J~._f( , 13 . Soil Type(s): fJ~ •
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 irrigat ion design or wettable
acres determination ?
Page2of3
QYes
DYes
DYes
DYes
DYes
DYes
DYes
00ther:
DYes
~No gNo
No
~No
lj] No
~No
~No
r29 No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
214/1011 Continued
~acility Number: '{Z.-bt?; < I !Date of Inspection: 7/;SJ!q . .. I
24. Dtd 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
DYes
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? DYes
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? DYes
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the 0 Yes
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes
D Application Field D Lagoon/Storage Pond D Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes
34. Does the facility require a follow-up visit by the same agency?
an~or any additional recommend~~ons
~No
~No
~No
~No
~No
~No
~No
~No
DNA ONE
DNA ONE
DNA ONE
D NA ONE
D NA ONE
DNA ONE
DNA ONE
DNA ONE
D NA ONE
DNA ONE
Reviewer/Inspector Name: Phone: lfw""(]-3-j3Gb
Reviewer/Inspector Signature: Date : zftr(rC£
Page3 of3 2/412011
Reason for Visit:
Operation Review 0 Structure Evaluation
0 Follow-up 0 Referral 0 Emergency 0 Denied Access
Date of Visit: I I oe I ArrivalTime:I/0-1/-Jll DepartureTime:LI ___ ....~I County:5J~ Region: tCbfj'tL
Farm Name: "TD t'<) J 0 L{
Owner Name: --:\Q Se f'>}... C Q 'S...D..c <}=
Mailing Address:
Physical Address:
Owner Email:
Phone:
----------------------------------------------------------------------------------
Facility Contact: Title: Phone: -------------------------------------------------
Onsite Representative:
Certified Operator: -::\0$.0 4J.h Ca ,) R"a
Back-up Operator:
Location of Farm:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Latitude:
VED
DEQ/DWR
Discharge originated at: 0 Structure 0 ApplicatiCWrf~el0 8 2~ Other:
a. Was the conveyance man -m ade?
Integrator: ---------------------------
Certification Number:
Certification Number:
Longitude:
DYes ~ DNA ONE
DYes 0No DNA ONE
ONE DYes 0No DNA b. Did the discharge reach waters of the S~Jey-k!fr£?' JJ}Iti~)
c. What is the estimated volume that reached waters~~~~ ~1-<;;WFICE ------------------------------
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes DNo DNA ONE
2. Is there evidence of a past di sc harge from any part of the operation? DYes ~0 DNA ONE
DYes 0No )2t'NA ONE 3. Were there any observable adverse impacts or potential adverse impacts to the waters
of th e State other than from a disc harge?
Page I of3 11411011 Continued
!Facility Number: '3 X-1.;3 33J I nate or Inspection: I() /1/ Jz3 I
r '
Waste CoUection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in): --
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e ., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes JA'No 0 NA 0 NE
0 Yes 0 No 0 NA 0 NE
Structure 5 Structure6
DYes ~No DNA ONE
DYes po 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 requ ired by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part ofthc 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
D Yes
DYes
JA:No DNA ONE
iz(No DNA ONE
Jlf'No DNA ONE
.(A'No DNA ONE
11 . Is there evidence of incorrect land application ? If yes, check the appropriate box below. D Yes ~o D NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metal s (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Type(s): /-{ QgA_.4.L:S (;(}'42
13 . Soil Type(s):
14 . Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application sit e n eed improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination'?
17 . Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste a pplication equipme nt?
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.
DYes .12(No DNA
D Yes ~0 DNA
DYes 0No DNA
DYes J21'No DNA
DYes ~No DNA
DYes J2fNo DNA
DYes ~No DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Owup 0 Checklists 0 Design D Maps 0 Lease Agreements 0 0ther: _________ _
21. Does record keeping need improvement? If yes , check the appropriate box below. 0 Yes JL(No DNA 0 NE
0 Waste Application 0 W eekly Freeboard D Waste Analysis D Soil Analys is D Waste Transfers 0 Weather Code
D 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 in stall and maintain a rain gauge? D Yes JZ{No D NA 0 NE
23 .1fselected, did the facility fai l to install and maintain rainbreakers on irrigation equipment? DYes ~o DNA 0 NE
Page2of3 214/lOII Continued
lFaciliiy Number: f3 0Z -(a :i5J I Date of Inspection: l 0-/) -J3 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 con~itions related to sludge? If yes, check
the appropriate box(es) below. ~ ~ ~ 0 I 3 -
DYes
DYes
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
Lis t 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 los s 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 in spection 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 Offi ce of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
DYes mo
DYes ~o
DYes j1No
DYes ~No
DYes lfJ'No
DYes lf] No 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other: -----------------------
32 . Were any additional problems noted which cause non-compliance of the permit 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?
,,~
I, 0 9
I .'7lj
) I~ 't
o,?3
DYes l71 No
DYes ~· DYes 0
or.aoy other
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
Reviewer/Inspector Name : --g~ ~
Reviewer/Inspector Si gnature: .... _..,~ilT"'~'-'-=--~..::...-eiii'~""-.._==--------------------­
Page3 of3
Phone: Cf/9!f I $";23b
oate: __ J~D--~-)........,1 Jf-l-j-~'-"J3'-----
2/4/2o11
Compliance Inspection Operation Review 0 Structure Evaluation Technical Assistance
Reason for Visit: e Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Region:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: -------------:-------------------------------
Facility Contact: ~ rJ ~~ Title:-----------Phone:
Ons;te Rep...,.otadv., (j IDtegrato" ~~
Certified Operato" J~ lj2_ (9~ Certilkadon Numbe" rr fb -zz_
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation? DYes p9No
Discharge originated at : D Structure 0 Application Field D Other:
a . Was the conveyance man-made? DYes 0No
b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No
c. What is the estimated volwne that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) D Yes 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 discharge?
Page 1 o/3
0 Yes;;! No
0 Yes "fJ No
DNA ONE
~NA ONE
NA ONE
~NA ONE
NA ONE
DNA ONE
l/4/20II Continued
I t, [-Facility-Number: loate of Inspection: '1h7{v
Waste ColJcction & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. lf yes, is waste level into the structural freeboard?
Identifier:
Structure 1
\
Structure 3 Structure 2 Structure 4
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3} lf
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 ~No
0 Yes 0 No
DNA D NE
~NA ONE
Structure 5 Structure 6
DYes ~No DNA O NE
0 Yes ~No 0 NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes
DYes
DYes
DYes
~No DNA ONE
~No DNA ONE
fJ No DNA ONE
~No DNA ONE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes 15ft No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > IO% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outs;d, of Amptoblo Cmp Wffidow D Ev;d'"" of w;nd Drift D Appl;oa~of Appmved Area
J2CmpTYP'(s) Gus:k( 'PJ«~t1. <bass ~L $,. @.4 0~
13. Soil Type(s): !JKh ljc.--fllt2 ft
14. Do the receiving crops differ from those desig nated in theCA WMP?
15 . Does the receiving crop and/o r 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 la ck adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit read ily available?
20. Docs the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
Owur O c h ccklists 0Design 0 Maps D Lease Agreements
DYes [lj No DNA ONE
0 Yes 1¥3 No DNA ONE
DYes f¥PNo DNA ONE
DYes ~No DNA ONE
DYes 9No DNA ONE
DYes ;No DNA ONE
D Yes No DNA ONE
Oother:
21. Docs record keeping need improvement? If yes, check the appropriate box below. 0 Yes cp No D NA 0 NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections D Monthly and I" Rainfalllnspections 0 Sludge Survey
22. Did the facility fail to in sta ll and maintain a rain gauge?
23 . I f selected, did the facility fail to install and maintain rainbreakers on irri gation equipmen t?
Page 2 of3
DYes ~No 0NA ONE
0 Yes ~ No 0 NA 0 NE
2141201 I Continued
liiacility -Number:
l J
fJ;1._-6~.> I Date of Inspection: 7]1'flt'Z.,_
r '
24. Did the facility fail to calibrate waste application equipment as required by the permit? O Yes tt" D NA ONE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes No D NA ONE
the appropriate box(es) below.
0 Failure to complete annual sludge survey 0Failure to develop a POA for s ludge level s
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? DYes ~No DNA O N E
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes ~No DNA O N E
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes ~No DNA ONE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? 0Yes ~N o DNA ONE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes ~No DNA ONE
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? Ifyes, check the appropriate box below. 0 Yes EfJ No DNA ONE
D Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes QQ N o DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? D Ye s ViJ N o DNA
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
Operation Review 0 Structure Evaluation
Reason for Visit: e Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other
Date of Vbit' r!!l!!!!!? Arrival T;me'l /i!UiiQf! Departure nmed 0/!~ounty'-~ Region '~
FarmName' /J2M JOt/--gc:k,;J a?e<t Owner Email'
OwnerName: 0~~:--g, ~~ Phone:
Mailing Address:
Location of Farm: Latitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field
a. Was the conveyance man-made?
0 Other:
b. Did the dis charge reach waters of the State? (If yes. notify DWQ)
c . What is the estimated volume that reached waters of th e State (gallons)?
Certification Number:
Longitude:
DYes ~N o
0 Yes 0 No
DYes 0 No
d . Does th e discharge bypass the waste management sys tem? (If yes, noti fy DWQ) DYes D No
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 th e waters
of the State other than from a discharge?
Page I tJj 3
0 Yes ;N o
0 Yes No
DNA ONE
~NA ONE
~NA ONE
~NA ONE
DNA ONE
DNA ONE
21412011 Continued
5"-l>s£ 1 I Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 2 Structure 3 Structure 4
Identifier;
Spillway?:
Desif,rned Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
D Yes ~ No D NA D NE
D Yes D No ltfNA D NE
Structure 5 Structure 6
D Yes ,0 No D NA D NE
D Yes ~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 DWQ
7 . Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes l¥il No DNA ONE
DYes f¥j No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
11. Is there evidence o f incorrect land appl ica tion? If yes, check th e a ppropria te box below. D Yes ~ No D NA D NE
D Exce ss ive Po nding D H ydraulic Overload D Frozen G round D H e a vy M e tals (Cu, Zn, etcf
D P AN D PAN > 10% or 10 lbs. D T o ta l Phospho rus D Failure t o Incorporate M a nure /Sludge into Bare Soil
D Application O utside of Appro ved Area
12 . Crop Type(s): ~
13 . Soil Type(s):
14 . Do th e r ece ivin g c ro ps di ffe r fro m those designated in the C A WMP?
15 . Does the receivin g c ro p and/or la nd application s ite need improve ment?
16. Did the fac ili ty fail to secure and/or op e rate per the irriga tion d esig n o r w e tta bl e
acres determinati on?
17. D o cs th e faci lity la ck adeq uate a c re age for la nd a pplicatio n?
18 . Is there a lack of prope rl y o perating w aste application equipment?
R equired Record s & Documents
19 . Did the facility fail to have the Certifi cate o f Cove ra ge & Permit re adily available?
2 0. D o c s the facility fail to have a ll co mpo ne nts of t he C AWMP r eadil y ava il a bl e? If yes, c hec k
the appropriate box.
OwuP O c heckli sts 0Des ign D Ma ps 0 Lease A g reements
DYes
DYes
DYes
DYes
DYes
DYes
DYes
O o the r :
~N o DNA ONE
09No DNA ONE
Q9 No DNA ONE
~No DNA ONE
D9 No DNA ONE
~No DNA ONE
~N o DNA ONE
2 1. Docs re cord kee ping ne ed impro ve m e nt? I f yes , check the app ro priate box bel o w . DYes ~No DNA D NE
D Was te Appli cation D W eekl y F reeboa rd D W aste Analys is D So il Ana lys is D W as te Transfers 0 W eathe r Code
0 Rainfall D Stocking D C rop Y ie ld D 120 Minute Inspec tions 0 Monthly a nd I" Rainfall Inspections 0 Sludge Surve y
22. D id the fa cil i ty fail to install and m ai ntain a r ain gauge?
23. If se lected , did th e fa cility fa il to install a nd mai n tain rai n breakers o n i rrigatio n equ ipment?
Pagelo/3
DYes ~No
D Yes ~No
DNA ONE
0 N A ONE
214/2011 Co ntinued
~ -~ 1' [Fa~ility..No.tmber:;>;F-P>> I loate of Inspection: ·Jr1 iS( n
DYes ~No D NA ONE 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 slud ge? If yes, check DYes ~No DNA ONE
the appropriate box(cs) below.
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s} and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? DYes ~No DNA ONE
27. Did the facility fail to sec ure a phosphorus loss assessments (PLAT) certification? DYes DNo ~NA ONE
Other Iss ues
28 . Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes ~No DNA ONE
and report mortality rates that were higher than normal?
29. At the time of the in spection did the facility pose an odor or air quality concern? DYes ~No DNA ONE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes ~No DNA ONE
permit? (i.e., discharge , freeboard problems, over-application)
3 I. Do subsurface tile drains exist at the facility? If yes, check the appropri ate box below. DYes ~No DNA ONE
0 Application Field D Lagoon/Stora ge Pond 0 Other:
32 . Were any additional problems noted which cause non-compliance of th e permit orCA WMP? DYes ~N o DNA ONE
33 . Did the Reviewer/In spector fail to discuss review/inspection with an o n-s it e representative? DYes ~No DNA ONE
34. Does the facility require a follow-up visit by the same agency? 0 Yes qlNo DNA ONE
Comment~:(ref~r;·to question#): Explain a ny YES answers and/or any additional recomm.e~}~~!i,?~:·r ·rla!!'Y.;oth ~(~ft~
Use drawings of facility to better explain situations·(use additional pages as necessary). -::~.~:~t,";J.tf.\t _ ;;;,l .,;,i::.:_: ·~· •' .. _. ·,;;;:·;.:.;;;,:.;;:';;;;;::===::;;;;-=:-=t
Reviewer/Inspector Name:
Reviewer/Inspector S ignature :
Page 3 of3
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 D Denied Access
Physical Address:-----------:--------------------------------
Facility Contact: ~ Nt &'YlO,J Title: -----------Phone No: ---------
Onsite Representative: It fL'c.W CQ.~~ Integrator: J11.~-~WV\.
Certified Operator: JOse('h /2' G:t~ Operator Certification Number: 17BZ Z
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 ~o DNA ONE
Discharge originated at: D Structure D Application Field D Other
a. Was the conveyance man-made? DYes 0No ~NA ONE
b. Did the discharge reach waters of the State? (If yes. notify DWQ) DYes 0No ¥NA ONE
c. What is the estimated volume that reached waters of the State (gallon s)? I
d. Does discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No ~NA ONE
2. Is there evidence of a past discharge from any part ofthe operation? DYes eyg No DNA ONE
DYes tiNo DNA ONE 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than rrom a discharge? -
Page I uf 3 12128104 Continued
J
··I Facility Number: B~-b~l Date of Inspection I I i/1 s-AD 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 Structure 3 Structure 4
DYes ~No .DNA ONE
DYes 0No ~NA ONE
Structure 5 Structure 6
Identifier: __ ___.I.__ __ ---------------------------------
Spillway?:
Designed Freeboard (in):-----.,..-....,....-----------------------------------
ll''"
Observed Freeboard (in): ___ .,=--r ___ ----------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes ~No DNA ONE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes 99No DNA ONE
DYes ~No DNA ONE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes '¥'No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 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. Cwptype('J Qa.s{J ~ G.a.:cS(/1~ )I)..,·~~~ 0~
13. Soil type(s) JJ61:(-t;' JJ:--tJ~A ,
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
DYes \CNo DNA ONE
DYes (lg>No DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? D Yes Q9 No D NA 0 NE
17. Does the facility lack adequate acreage for land application? rp No
Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer II nspector Signature:
Page 2 of 3
Phone: 9/o-~"3 J~J 300
Date: 12..-/S-10
12128104 Continued
., Facil.ity Number: 8~ -')5fl Date oflnspectioo I tl{lc;po I
Required Records & Documents
19 . Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box . 0 WUP D Checklists 0 Design 0 Maps 0 Other
DYes ~-No DNA ONE
DYes ~No DNA ONE
21 . Does record keeping need improvement? If yes , check the appropriate box below . 0 Yes 9l.No 0 N A D NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysi s 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25 . Did the facility fail to conduct a sludge survey as required by the pennit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to sec ure a phosphorus loss assessment (PLAT) certification ?
Other Issues
28. Were any additional probl ems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than nonnal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regio nal Air Quality representative immediately
31. Did the facility fail to noti fy the regiona l office of emergency situati ons as require d by
G eneral Permit? (ie/ di scharge, freeboard problems, over application)
32. Did Re viewer/Inspector fail to discuss review/inspec tion with an on-site representati ve?
33. Does facility require a follow-up visit by same agency?
Page3 oj3
DYes ~No DNA ONE
D Yes DNo ~A ONE
D Yes ~No DNA ONE
DYes '¥No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
D Yes ipNo D NA O NE
DYes ~No DNA ONE
DYes ~No DNA ONE
D Yes ~No D NA ONE
DYes ~No DNA
12118104
-~~~liii-I!!IIIIIIIIIJ
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 D Denied Access
Date of Visit: lli/Li/ilf I Arrival Time: I06,JOa,._.J Departure Time: I tfi../!{}jP. I County: c9Jd£MV' Region~
FarmName: {(,k),tJerd c:d~-T0/11 /tJtj OwnerEmail: -----------
Owner Name: .!::}'~/, (2_. ~ . Phone:
Mailing Address: -----------------------------------------
Physical Address: ---------::-----+-------------------------------_kP~~::...::r-:?!!!)==1~~-!'.:=f!At:::..:...LJo~n.:...l.Cl:::;;.J,..._· ___ Title: ----------Phone No: --------
Onsite Representative: ----~~--------------Integrator: t/lwpAy ,.... 8Yf)e.JI1 LLL
Facility Contact:
Certified Operator:--------------------Operator Certification Number: -------
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude: D OD'D"
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes ~No DNA ONE
Discharge originated at: D Structure 0 Application Field D Other
a. Was the conveyance man-made? DYes DNo ~NA ONE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes DNo p5LNA 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 DNo J29'NA ONE
2. Is there evidence of a past discharge from any part of the operation? DYes !)a No DNA ONE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State DYes ~0 DNA ONE
other than from a discharge?
12118104 Continued
I Facility Number: e ~-at I Date of Inspection I I dt7/i81 . I
~C ollection & Treatmen t
4 . Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? DYes ~No DNA ONE
a. If y es. is waste level into the struc tura l freeboard ?
StnJcture 2 Structur e 3 Structure 4 S~c~::~ 5O No s!~:rc ~ NE Stmcfture I
Identifi er: __ ___,_.____ __ ------------------------------
S pillway?:
Des igned Freeboard (in):
--@"'W"-:::""7:ljr---
Ob servcd Free board (in): ---=~:;....:z ___ ------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(iellarge trees, severe erosion, seepage, etc.)
0 Yes r5fNo 0 NA 0 NE
6. Are there structures on·site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/imptovement?
D Yes ~0 D NA ONE
D Yes 9No DNA ONE
DYes tyJNo DNA ONE
D Yes DNA ONE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes !5p No 0 NA D NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu. Zn, etc.)
D PAN 0 PAN > 10% or 10 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12 . croptype(s) ~dJ. fk-mJa ~ss ~1 -~c ~btJ~
13. Soil type(s) IJH-.fol~fJprf
14 . Do the receiving crops differ from those designated in theCA WMP?
15 . Does the receiving crop and/or land application site need improvement?
D Yes
DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination'i 0 Yes
17 . Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
DYes
DYes
fj1No
~No
~No
~No
¥No
Comments (refer to question #): Explain any YES answen and/or any recommendations or any other comments.
Use drawiDp of facility to better explain situations. {use additional pages as necessary):
Reviewerllnspec:tor Name --+~~~CJ~~~+-------------Phone:
Reviewer/Inspector Signature: Date:
DNA
DNA
DNA
DNA
DNA
ONE
ONE
ONE
ONE
ONE
12118104 Continued
.-·1 Facility Number: 8~ -£,$!" I
Required Records & Documents
Date of Inspection I ti/i 2)tA I
I
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components ofthe CAWMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps D Other
DYes r,8lNo DNA D NE
DYes ~No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes l!:JNo 0 NA D NE
D Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification
0 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance ofthe permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and /or document
and report the mortality rates that were higher than normal?
30. At the time of the in spection did the facility pose an odor or air quality concern?
If yes , contact a re gional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ic/ dis charge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33 . Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings: ·.·. ·
Page 3 of 3
DYes ~0 DNA ONE
DYes f¥m'o DNA ONE
DYes ~No DNA ONE
DYes (a No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~0 DNA ONE
DYes ~0 DNA ONE
DYes Qf.No DNA ONE
"
DYes l11No DNA ONE
0 Yes ~No DNA ONE
12128/04
.... -
1-.....
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 D Denied Access
Date of Visit: I l t/6@ I Arrival Time:~ !QQqq.l Departure Time: IJO:'{S"tt""l County: Sft-rv1P>DAI . Region: FRD
Farm Name: TOM lOt/ -£'d.arJ CQ~ Owner Email: -----------
Owner Name: JOSe_pJ, fl.., Casery Phone:
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: P0j M'..vmonJ Title: -----------Phone No:---------
Jt
Onsite Representative: -------------------
Certified Operator: :JoSA(Jh fl. Ca~ ---------
Integrator: __ 1+Av,A~IIKyf~~=I----------­
Operator Certification Number: __:_/_7_,9.:::~"'--""~=------
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? DYes ClfNo DNA ONE
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)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
DYes 0No ~NA ONE
DYes 0No ~NA ONE
I
DYes 0No rfANA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
12128104 Continued
I F!J£ility Number: e~ lb~ I Date of Inspection I fi/6/0e I
Waste Collection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes ~No DNA ONE
DYes 0No 5aNA ONE
Structure 5 Structure 6
Identifier: __ .... { ____ ---------------------------------
Spillway?:
DesignedFreeboard(in): __ -r-!'..,......------------------------------------
Observed Freeboard (in): ___ 4~-.1.L.-tl __ ------------------------------
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 5QNo DNA ONE
If any of questions 4-6 were answered yes, and the si tuation 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 pennit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
DYes ~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 ~No 0 NA 0 NE
0 Excessive Ponding 0 Hydrauli c Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/S ludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Eviden ce of Wind Drift 0 Application Outside of Area
12. C rop type(s) Coa.sfz,J Ser-muk Gnus-GJ(L~J 5111 • jrQJn I>~~
13. Soil type(s) _pput:.wL-ck:I:::~l.r::k..:............ __________________________ _
14. Do the receiving crops differ from those designated in theCA WMP?
15 . Does the receiving crop and/or land application si te need improvement?
DYes
DYes
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?O Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
GocJ ~~­
G-o.J v-ee~~·
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Pagel of 3
DYes
DYes
12/28104
f1JNo DNA ONE
t:iNo DNA ONE
flJNo DNA ONE
~:No DNA ONE
$-No DNA ONE
Continued
I Pacili~ Number:. f)2. -60$[' Date oflnspection I I {/;J'og J
Reguired Records & Documents
19. Did the facility fail to have Certificate ofCoverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists D Design D Maps 0 Other
21. Does record keeping need improvement? lfyes, check the appropriate box below.
DYes fYJNo DNA ONE
0 Yes fS!No 0 NA 0 NE
DYes ~No DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers D Annual Certification
0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes }pNo DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes &No. DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes ~No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes _KjNo DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes JS3No 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 FpNo DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notifY the regional office of emergency situations as required by DYes ~No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes [)!No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes DNA ONE
Page3 of 3 12/28104
~~~~~==~~~==~~~~~~J
r
• Division of Water Quality
Facility ~umber 1 .... ~-7 .H --~-~.JI g ~~=~o=::n~;il and Water Conservation _:.~~~: -~~~·!":! .. ~
; :·:~~~;Ji~
Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation () Technical Assistance
Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: 11/1?/01 I Arrival Time: l iB :'(/Jq.Al Departure Time : I 09~ 1J' Q~ County:
Farm Name: 7PM JOt.{ /1..., ~ ~ t/_~ Owner Email: -------------
Region: f:l!i>
Owner Name: (2/ckJ C4.~ Phone:
Mailing Address: ----------------------------------------
Physical Address:-----------------------------------____ _
PhoneNo: ________ _ Facility Contact: Do~ ,J,·~{J Title:
Ons;te Rep,..,entati•eo ~~·· g 'JV.Ml Gz>ry Integrator: _fL.L.c:..• -~::...:..;..-·-----------
Certified Operator:----------------'------Operator Certification Number: _...:../_7.;...9.::;._~_~ ___ _
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD 'D " Longitude: D OD'D"
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
J I Ji 10 Layer I I I
0 Non-Layer .!
ID Wean to Fini sh
I2SJ Wean to Feeder 3~2.0 'f21b
0 Feeder to Fi nish
0 Layers
0 Non-Layers i
0 Pullets
0Turkeys
0 Farrow to Wean
0 Farrow to Feeder
D Farrow to Finish
D Gilts
D Boars
--·-·· --· -.
Dry Poultry
Other 0 Turkey Poults
0 Other ID Other --. -· -
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure D Application Field D Other
a. Was the conveyance man-made?
b. Did the discharge reach wa ters of the State? (If yes. notify DWQ)
Cattle
ODairyCow
D Dairy Calf
0 Dairy Heife1
0 Dry Cow
0 Non-Dairy
0 Beef Stocker
0 Beef Feeder
Design,:; ~c~ri:~~t · .~ •.
c apacitY :,PopUiap9.i--!· ... ;. -~ ~.-r,
~
' ;
' '
(
!
' 0 Beef Brood Cow I
··---· ... -
Number of Structures:
DYes i9No DNA ONE
DYes 0No ~NA ONE
DYes 0No [ljNA ONE
c. What is the estimated volum e that reached waters of the State (ga ll ons)? I
d. Docs discharge bypass the waste management system? (If yes, notify DWQ)
2 . Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impact s or pote ntia l adverse impact s to the Waters of the State
other than from a discharge?
DYes 0No ~NA ONE
DYes ~No DNA ONE
DYes ~No DNA ON E
11/28104 Continued
.I ,.
I Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heav y rainfall) le ss than adequate?
a. If yes, is waste level into the structural freeboard?
Structure l Structure 2 Structure) Structure 4
DYes ~No DNA ONE
DYes 0No J9NA ONE
Structure 5 Structure 6
Identifier: __ .._( _________________________________ _
Spillway?:
Designed Freeboard (in):-----:-::~,....---------------------------------------
3 .-,tf
Observed Freeboard (in): ____ '--------------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes ~o DNA ONE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? 0 Yes ~No 0 NA D NE
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
DYes fiSINo DNA ONE
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
DYes ~No DNA ONE
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~No 0 NA D NE
D Excessive Ponding 0 Hydra ulic Overload D Frozen Ground 0 Heavy Metals (Cu., Zn, etc .)
0 PAN 0 PAN> 10% or 10 lbs 0 Total Pho sphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12. Croptype(s) ~J[J,), ~.Gr.()~
13. Soil type(s) -+rJ.:.J&-r{J~IU.-L.~-------------------------------
14 . Do the receiving crops differ from tho se designated in the CAWMP? 0 Yes ~No 0 NA 0 NE
15. Does the receiving crop and/or land application site need improvement? 0 Yes fiCil No 0 NA 0 NE
16. Did the facility fail to secure and/or operate per th e irrigation design or wettable acre determination?O Yes ~No 0 NA 0 NE
17. Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
DYes aNo DNA ONE
DYes "93No DNA ONE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name ---...;::6fl~:z:Il4-L7!-,:::.:.....:-/J.ti?--------------Phone: \..-fi-M.f-t-H,_,....:;....-..;;...;;...._
Reviewer/Inspector Signature: Date:
Continued
. ...
I Facility Number: B~-pssf
Required Records & Documents
J I
Date oflnspection 111/?{b? I
I
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other
DYes J1No 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 D Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall D 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25 . Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted whi ch cause non-compliance of the permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did th e 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/ins pection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
Additional .Comments and/or Drawings:
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
12128104
[2fNo DNA ONE
~No DNA ONE
~No DNA ONE
~No DNA ONE
00No DNA ONE
~No DNA ONE
~No DNA ONE
lij No DNA ONE
~No DNA ONE
~No DNA ONE
~No DNA ONE
f8No DNA ONE
·. ·=~·-.J~t;·~~~~.·~~ ... -
~ ...... e Division ofWater Quality
0 Division of Soil and Water Conservation
0 Other 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 Jo/.2~/ 061 Arrival Time: I fJB.'SO~tw-1 Departure Time: I {}ij!?;ba;.j County: S/tv't"'fSoN
r '
Farm Name: ____.T ....... D""'"'M~-"-() ...... tf___._R..;.;...,'ch_an;{....;.....;;...~Cg=-~~~---
!'' I I /'_
Region: H.'D
Phone:
Owner Email: -------------
Owner Name: __ 'Sf....,_;:~=-=...;....;;..;,_CJ.l=""'~""""#--------------
Mailing Address: {o9Jat.( lfo{J,]plt t&rl d~~ AJc._ -=~=....::::3-=-?B:J.L--________ _
Physical Address:----------------------------------------
FaciUty Contact: R,\cJ,\an} Cg~ Title: -----------Phone No: ---------
Onsite Representative: _.l<~loho:;;;· -'=ad~....__{Q-=~~.,.___________ Integrator: ftei'Vl/4!V\ S~kJ.
Certified Operator:--------------------Operator Certification Number: /1 S ~ ~
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm:
Discharges & Stream Impacts
Latitude: D OD'D"
· Des~~: ... C~rrent
Wet Poultry Capacity Pop'ulation
Longitude:
I . Is any discharge observed from any part of the operation? DYes !&!No DNA ONE
Discharge originated at D Structure 0 Application Field D Other
a . Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c . What is the estimated vo lume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'! (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of3
DYes 0No llJNA ONE
DYes DNo ~NA ONE
I
DYes 0No !l)NA ONE
DYes ~No DNA ONE
DYes lf No DNA ONE
12118104 Continued
·J FacilitY Number: Be?.-~5""~ I Date oflnspection I !0/a:rjok I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
DYes .IJ"1No DNA ONE
DYes 0No ~NA ONE
Structure 5 Structure 6
Identifier:----'-'---------------------------------------
Spillway?:
Designed Freeboard (in): __ _.{~q~-.:--------------------------------
111} I(
Observed Freeboard (in): ___ :!...L..J:...__ __ -----------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes ~No DNA ONE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
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
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes
DYes
DYes
DYes
~No DNA ONE
~No DNA ONE
~No DNA ONE
~No DNA ONE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~ No D NA D NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc .)
0 PAN 0 PAN> I 0% or I 0 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 Application Outside of Area
12. Crop type(s) ~~Ja. Hay
1
S ooa,.U tF-z:y h {Jro/Sfiq,J
13. Soil type(s) ____.N;...::.· ~or~.....bJ....:..!feo.k~--------------------------
14. Do the receiving crops differ from those designated in theCA WMP? DYes [iNo DNA ONE
15. Does the receiving crop and/or land application site need improvement? DYes 1)?1 No DNA ONE
\
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination '! DYes liJ No D NA D NE
17. Does the facility lack adequate acreage for land appli cation? DYes cyiNo DNA ONE
18. Is there a lack of properly operating waste application equipment? ONE
. _:;:~:.-~--~ ; -·' :
Explain anyi;.YES answers .ll~ly;,J:.ec:~n;·1Jl~Ditlati011S. or any other COIIIIIII_t:,!!.'
fa(:ili1tY~;itj)\l,etter explain sitU'~tio~s. (1_1se aaa.amm~a• p,agt;S .;~'Ilel~essaJry):
Reviewer/Inspector Name
Reviewer/Inspector Signatu
Page 1 of3 11118104 Continued
"
I Facility Number: B ~ -69.:' I Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box. 0 WUP 0 Checklists D Design 0 Maps 0 Other
DYes ~No DNA ONE
DYes QlNo DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes !Sa}No 0 NA 0 NE
0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification
0 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?
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the pennit 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 pos e an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to noti fy 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 representativ e?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:
Page 3 of3
DYes ~No DNA ONE
DYes 0No ~NA ONE
DYes fa No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes l»No DNA ONE
DYes ~No DNA ONE
DYes 00No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes fjlNo DNA ONE
DYes ~No DNA ONE
._' ·;·}, .-:. ~:--~' :r-~~t."~~~
12/18104
...... -
1--.....
Type ~f 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
DateofVisit: lJ·'{-~)' I Arri\·aiTime:l2.'oO,. I DepartureTime: ._l ___ __.l County: ..S~, • Region: £/lo
Farm Name: Owner Email: --------------
Owner Name: ___ J:I£.Sii4'-~\Suc',..,.e""'j,.____,/?'-'-'-',c"'-~..:.Q=<r'-"rfa. _ _.L;......Jic;riiLo.sil..l'/Y'<.c__------Phone:
Mailing Address: _./..:'C;..,o8,...'$~~--H.t...UGo't:!!<>ol.-,L.;f6"""'"'----H.L.L!..'"If-=L/~...,,_., cya.,)'!v:____ _ ..... LOcl-</'t..!.:,u/,~.,L.Oo-fJ----"M..JC..;:~=-------..::2$3 .:2 8
Physical Address:-----------------------------------------
Facility Contact: _.e4 I r'ctj> 1 LJc, "' /1<,;,../ritle: -----------Phone No: ---------
Onsite Representative: £.'o/,_,,/ f:O~ •' l?o"j N~;"'"" ,j Integrator: 8t!,.,, ·(t, .St011al'o,e(
Certified Operator: __ __.f(..&.......::J,=g,..,"-',/..,___ Cpu) Operator Certification Number: I '7 B;;;:2
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 ~o DNA ONE
Dis charge originated at: 0 Structure 0 Application Field 0 Other
a. Was the conveyance man-m ade?
b. Did the discharge reach wat ers of the State? {If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? {If yes , notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes ~0 DNA ONE
DYes B'No DNA ONE
11128104 Continued
I Facility Number: 9;2 -{,t;) I Date of Inspection 13-Lf-od
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 [31(o' DNA D NE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier: -'-~··;:;:"-;;..:/;s;::..""' ___ -------------------------------
Spillway?: /117
L.Jr,. Designed Freeboard (in): L , ~~~
Observed Freeboard (in): · ?, '7 :~c.:...
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
0 Yes G:t'N'o DNA D NE
6. Are there structures on-site which are not properly addressed and/or managed DYes [31.Jo DNA D NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public bealtb or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures 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 Ga'No DNA ONE
DYes ~o DNA ONE
DYes ~o DNA ONE
DYes gNo DNA ONE
11. Is there evidence of incorrect application? Ifyes, check the appropriate box below. 0 Yes [3"No DNA D NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu , Zn, etc.)
D PAN D PAN > I 0% or I 0 lbs D Total Phosphorus D Failure to Incorporate Manure/S Judge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
:;;;p~r, ro
12. Crop type(s) 4t=,.n«~ 5,_4 /1 ha,a
13. Soil type(s) _M~'Jc~D~{i~lfL__ ____________________________ _
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
DYes ~o DNA ONE
DYes ld'No DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination! 0 Yes 0 No DNA I3'NE
0No DNA EfNE
~DNA ONE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack ofproperly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
DYes
DYes
Phone: 91~ 'I~· I$ e,,-I)Yo
Date: "3-'t ~OS::
11118/04 Continued
. . ~
j Facility Number: 8.:1 -ttr I Date of Inspection I .?· v ·or I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 ~ 0 Ch~ D D# D~s 0 ~
21. Does record keeping need improvement? Ifyes, check the appropriate box below.
DYes l3-NoLJ NA 0 NE
0 Yes 8'NO DNA ONE
~ DNo DNA ONE
~ 0 Weekly Free~ml-D Wftste Analysis D Soil Analysis D Waste'TF!Hl§fers D Amtaal Ce•tit1eatisR.
0 Rainfatt-0 8teek:iftg D Crop Yield G12o Minute Inspections ~nthly and I" Rain Inspections 0 \'leather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notifY the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
~ DNA ONE
0No DNA ~E
0No DNA ~E
0No DNA [;3-N£
~0 DNA ONE
DNo DNA G;HqE
[d'No DNA ONE
0""No DNA ONE
la'No DNA ONE
E2f'No DNA ONE
@'"No DNA ONE
BNo DNA ONE
~~ ... ...:; ¥ i "'-"? ~ ~ •· • t • • ,
': . ' .
..Z( fJ/i'tt.se l'l~tc~ o-F Jd,Sf I ..s-d lttrl-t:Q,. .. lf~eo-/s, " c,_ Y~-J ,,.
f!~->~ ;~,·1~1 col{,lllfn on "XIM-1 -t:a,.,., -FOr-/:Jo "?'! ,.., u ft: ,',s~-1-,·,,.s,
fle-~t ; ".-t .. J 'Ft~f' I"VV n /-1, / v
/
f41J J-·Mr I ,, rat.-.r, If ' {.. t'f$~t; .... 5
12128104
\
Reason for Visit 0 Emergency Notification 00ther 0 Denied Access
facilif)·!\umbcr 1 P;t H iDP 'S$ ~D~tt·of\·i ~i t: 13/Dtt/oijTime: I 1/:Do
L _ _::..:,:.:.:.:_.:....:,_:.::.:,:__:=:::::=::__::~:::::::::: _ _! IO !\ot Operational 0 Below Threshold
C Permitted [J Certified 1fJ Conditionally Certified C R~stered Date Last Operated or Abo ve Threshold:
Farm !\ame: J"'osq" ~~ f,u.... Count)·: 5~~$"'"
Owner !\ame : k(" {A~ -------:-----Pbone No : -"'-9_1o_-_S:L....;..9_,_1f_-_.:....;/~~'-~'.;...._-----
MailingAddress: /06iL/= 1/Jin,. ~"1 · ~J;"''*>'I, N(...::.__.:o_Jf~5a=c'---------__ _
Facilif)· Contact: Phone !\o: __;...R.:....;..;i~~J::;...___::6t~~=4----T'tl e: ______ _
f?:d,.,J (}.~~ Integrator: _ _.~....;..;;.....-'-;-~_..;;;..~=-'-..r;....;J;;............ __ _
Certified Operator: __ ..... ~..c:..~r::.;:L-~!.....lo..{!...;.A.;;::S:....1~ -----------
Onsite Representath·e:
Operator Certification !\umber:
Location of farm:
0 CaHie O Horse Latitude '----....Jj• L-1 _ ___,I' 1'--_ _..1" Longit ude
Design Cnrrent Design Current Design Current
Swine Capacin· Population Poultry Capacity Population Cattle CaJ!acfu· PoJ!ulation
~ean to Feeder 3i.W 3t;lo 10 Laver I I I IODauv I I I D Feeder to Finish 10 Non-Laver I I J :o Non-Dairv:
D Farrow to Wean
IDOtber I ] Farrow to Feeder I I
D Farrow tO Finish Total Design Capacity I ~M I D Gilts I I ] B oars Total SSLW
Number of Lagoons I I I ID Subsurface Drains Present liD Lagooo Area ID Sern Field Area I .
Holding Ponds I Solid Traps I I .ID !\o Liguid Waste Management s,•stem I ;: .. :: ~.' . ·.~ < ~ ! ...
Di scbaroes ~ Stream Impact~
1. Is any discharge observed from any pan of th e operation?
Discharge originated at: 0 Laswon 0 Sorav Field 0 Other
a. If discharge is observed, was the conveyance man-made?
b. l f discharge is observed, did it reach Water of the State? (lf yes, notify D WQ)
c. If discharge is obsen•ed. what is the estimated flow in gaVmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there e,·idence 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?
~ Collt:(;tion & T reatment
4. Is storage capacity (freeboard plus stOilD storage) less than adequate? 0 Spillway
Structure I Structure 1 Structure3 Strucnrre4 Structure 5
Identifier:
DYes ~
D Yes 0No
D Yes 0No
DYes 0 No
D Yes 0 No
DYes ~
D Yes B<
Structure 6
Freeboard (inches): ~"' ,·e<.L~ ----~------------------OS/03101 Continued
I Facility Number: Z?. -C S"~ I Date of Inspection tl: oo
5 . Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public bealtb or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Docs any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Apolication
I 0 . Arc there any buffers that need maintenance/improvement?
II . ls there evidence of over application? D Excessive Ponding D PAN D Hydraulic Overload
12 . Croptype ,...~ ~""'
13 . Do the receiving crops differ with those signated in the Certified Animal Waste Management Plan (CAWMP)?
14 . a) Does the facility lack adequate acreage for land application?
b) Docs the facility need a wettable acre determination?
c) This facility is pendcd for a wettable acre determination?
15 . Does the receiv ing crop need improvement?
16. ls there a lack of ad equate waste application equipment?
Required Records & Documents
17. Fail to have Certifi cate of Coverage & General Permit or other Pennit readily available?
18. Docs the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design , maps, etc.)
19. Docs record keeping need improvement? (ie/ irrigation, fre eboard, waste a nalysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at t he time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
23. Did Revicwerllnspector fai l to discuss review/inspection with on-site representative?
24. Does facility require a follow-up visit by same age ncy?
25. Were any additional problems noted whic h c ause noncompliance of the Certified A WMP?
DYes ~
DYes ~
DYes ~
DYes ~
D Yes ~
DYes ~
DYes @t~o
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~ DYes
DYes ~
DYes [3"N'o
D Yes ~
DYes [3'No
D Yes ~
DYes ETNo
DYes ~
DYes g.r(o
DYes ~
You will receive no further correspondence about this visit..
~ ~f;) b .. Jr. -Ac.IJ ~
ooJ fl!~>
1
fi ;q_ ~ .
Reviewer/Inspector Name
Reviewer/Inspector Signature:
05103101 Continued
I Facility Number: ~!). -~~I Date of I ospection I ~~~ !/oLJl1
!M2[ Issues
26. 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?
27. Are there any dead animals noCdisposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade{s), inoperable shutters, etc.)
3 I. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or~ permanent/temporary cover?
05103/01
DYes ~
DYes
~·
DYes ~
DYes ~
DYes ~
DYes ~
DYes ~
'· --
I I Date of Inspection ·I ;l.;3j I~ Facility Number I ~l: H~ I Time of Inspection 11 lr>3/&J'"1 I' br. (bb:mm)
D~ered D Applied for Permit
Total Time (in fraction of hours ~~~s='l Farm Status: B!f£ertified (ex :l.25 for 1 hr 15 min)) Spent on Review
0 Permitted or Inspection (includes travel and processio~)
0 Not Operational Date Last Operated: ···-····-·-···-----··-·~·-····-·-·--··-··---·----···-·-·-·-:· ...
Farm Name: _:__ .. £.!"<-~Ov-~~hl.~----
Land Owner Name: ~h<N-~ ... --~ ·-· --····-····-····--····-:.... Phone No:--····'-"'\~~~-····-····-··--····-····-···---
Facility Conctact: ___ ~ --.. ··-···-· .. --Title: ___ Q......;_~ Phone No: .. -·--··--·-
Mailing Address : ........ ..l.Lk....lliA:' ... G,.!:~-~-~---~!:::-_ .... -.... -.. ---····· __ }J~ ..... (b"'···b~_t-~~-.... ~~ ~-
Onsite Representati,:e: ·-·-U..Ql.L.~..(.~~~--··--.. -----Integrator: _ .... ::::1:1)~-.. ---····-.. ·~---·
Certified Operator: --... ~· -:.~~1_ ..... ··-····~ .. --·--Operator Certification Number:_::.:::::-__ . --
Location of Farm:
Longitude!,_ _ _,1•1 ,_ _ _.1•1,______.1"
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Lagoon D Spray field 0 Other
a . If discharge is observed, was the conveyance man-made?
b . If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c . If discharge is observed , what is the estimated flow in gaVmin?
d. Does discharge bypas s a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any p art of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/9 7
maintenance/improvement?
DYes rzfNo
DYes JlfNo
DYes ~o
DYes ~o
c---
DYes .,tfNo
DYes tlNo
DYes ll:f'No
DYes o/No
Continued on back
I Fa~ility Number: .9..2:. ... _-2J!3_J
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
1. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (La~oons and/or lloldin2 Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure 1 Structure 2 Structure 3
---~·-··-
1 0. Is seepage observed from any of the structures?
Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate pubUc bealtb or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximwn liquid level markers?
Waste Application
14. Is there physical evidence of over application?
StructureS
(If in excess of WMP, or runoff entering waters of the State, notifY DWQ)
15. Crop type --···· ~-0::6+:.4 ...... -···-~·-··--·············-···········--····-·-····-·····-····--·-·---··--····-····-···-
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (A WMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
For Certifird Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified A WMP?
24. Does record keeping need improvement?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
cc: Division of Water Quality, Water Qua/it}' Section, Facility Assessment Unit
DYes {]No
DYes glNo
DYes J2fNo
DYes~
Structure 6
DYes ~o
DYes f.'No
DYes p1No
DYes pfNo
DYes ~0
DYes ~0
DYes ~
DYes ~0
·DYes ~0
DYes ~ 6: DYes
DYes 12(~
DYes ffyo
DYes i!fNo
4/30/97