820661_INSPECTIONS_20171231

NORTH CAROLINA
Qepartment of Environmental Quality
Date of Visit:j z; F--1_21 Arrival Time: I t ,·o 0 Departure Time :I I 0 : i) ol County :~~ Region: fi= fJ
:::::~:~, {/r~c0r:;; r;~:;;· 1-~ :::Email:
---------------------------------
MaUing Address:
Physical Address:
Title:~~ Phone:
Onsite Representative: Integrator: /? ~~ ~
Certified Operator: Certification Number: I Z 79-..;:z_
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? 0 Yes Lii_No DNA ONE
Disc harge originated at: 0 Structure 0 Application Field 0 Other:
a. Was the conveyance man-made?
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)?
d. Does th e discharge bypass the waste management system? (If yes, notify DWR)
2 . Is there evidence of a past discharge from any part of the operation?
3. Were .there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a di scharge?
Page 1 of3
D Yes
0 Yes
0 Yes
0 Yes
0 Yes
0No DNA ONE
0No DNA ONE
0No DNA ONE
~0 DNA ONE
l;aJ'Jo DNA ONE
114/1015 Continued
.; !Facility Number: V-&te I "
I Date of Inspection: ~ -azr-1 Y I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure) 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, seepag~, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes [31\fo 0 NA 0 NE
0 Yes 0 No 0 NA 0 NE
Structure 5 Structure 6
0 Yes 12J--No 0 NA 0 NE
DYes 12].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 ofthe 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
~No DNA ONE
[2?!_No DNA ONE
@.No DNA ONE
~ D N A ONE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~ 0 NA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metal s (Cu, Zn, etc .)
0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area
12. CropType(s): ~f'"~ /t.!Js.X-{:-:,zrl
13. Soil Type(s):
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
0WUP Ochecklists 0 Design 0 Maps 0 Lease Agreements
~0 DNA
DYes ~ DNA
DYes ~ DNA
DYes ~ DNA
DYes ~ DNA
DYes ~ DNA
0 Ye s ~ DNA
00ther:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. [3'Yes 0No DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Wa ste Transfers D Weather Code
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfalllnspection s EtSJudge Survey
22. Did the facility fail to install and maintain a rain gauge? D Yes [3"1"fo 0 N A 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes E:YN'o 0 NA 0 NE
Page2of3 214/1015 Continued
·' I Facility Number: tO-. 0~£ I Date of InsJ:!ection: 0-PJ.-x--;~ I
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~0 DNA
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes Ef11o DNA
the appropriate box(es) below.
D Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating nun-compliance:
~ 26. Did the facility fail provide documentation of an actively certified operator in charge? DYes DNA
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes EfNo DNA
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes EfNo DNA
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? DYes E]1fo DNA
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes @No DNA
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 Yes EtNo DNA
0 Application Field 0 Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~0 DNA
33. Did the Reviewer!lnspector fail to discuss review/inspection with an on-site representative? DYes EJrro DNA
34. Does the facility require a follow-up visit by the same agency? DYes ~ DNA
. -J-c 5£p"c-c:.5uv7 cl'f7--e-..5-1 /-IY ..>Ae>-t:dei hau <-~ 1?1'DI"r r~·
rr!J .$~-rl~ r-~.5~~~ l)r/lYa~-f:z_~ .!JT;J( Av~j..J--c:,
.h/C ~-r-3 ~ 7-P/J-/DLA--C( er/-
5F &I ;:, J',_.J--r -ri.~~ 'F -;-/. r~ you_ Jl.lrr) ~ /Purl::;/•~ 4-Ttl
olr:r;:;-,n.,_ -d-e-_ Trr~_...) 1/oltt.l"f r:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/Inspector Name: Phone : 9-(z;---p3-t>IS/
Reviewer/Insp ector Si gnat ure : Date : (..,:, ~~/Y
Page 3of3 2/412015
Reason for Visit:
Date ofVisit: I k~1 71 Arrival Time:l 'T! 2-£;> I Departure Time:l/0! 30 I County:-¥o--Region:
Farm Name: Cot, rr pe~ rd/111:3> 5nc.. /·-t..{ Owner Email:
(
Owner Name: ~ o kc:/= 5 C q ~r-Phone:
Mailing Address:
Physical Address:
Facility Contact: Phone:
Onsite Representative: Integrator: ?r Cz~
Certified Operator: Certification Number: J 7 7/:2-
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? D Yes _[:B-No DNA ONE
Discharge originated at: 0 Structure D Application Field D Other:
a. Was the conveyance man-made? DYes 0No DNA ONE
b. Did the discharge reach waters of the State? (Ifyes, notify DWR) 0 Yes 0No DNA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) 0 Yes DNo DNA ONE
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 ofJ
0 Yes
0 Yes
diJ No DNA ONE
1.)21 No DNA ONE
11412015 Continued
[Facility Number: !Date of Inspection: f.~! -2-< 7
( Waste CoUection & Treatment
• 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in): IT
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
D Yes D No D NA 0 NE
Structure 5 Structure 6
0 Yes (iJ No D NA 0 NE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify 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
DYes ~o
DYes _l;ZJ._No
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~o DNA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 1bs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. CropType(s): Jfr-/tnktJ'f.:~./ ~v...,.-c:t~J
13. Soil Type(s): N of}-=
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the inigation design or wettable
acres determination?
I 7. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components ofthe CAWMP readily available? If yes, check
the appropriate box.
0WUP Ochecklists D Design 0 Maps 0 Lease Agreements
21. Does record keeping need improvement? lfyes, check the appropriate box below.
DYes [g!No DNA ONE
DYes ~No DNA ONE
DYes J2a.No DNA ONE
DYes ~No DNA ONE
0 Yes ~No DNA ONE
DYes []l No DNA ONE
DYes ~No DNA ONE
00ther:
DYes ~No DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysi s 0 Soil Analysis 0 Waste Transfers D Weather Code
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? D Yes QSl No 0 NA 0 NE
23 . If se lected, did the faci lity fail to install and maintain rainbreakers on irrigation equipment?
Page 2 of3
DYes ~N o DNA ONE .
114/2015 Continued
.
:
!Facility Number: ~ Cztr.l I Date oflns~ection: (p ;;2-..;2o1Jo
24. Did the fac ility fail to calibrate waste application equipment as required by the permit? DYes ~0 DNA ONE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes lia_No DNA ONE
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 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 exi st 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 CA WMP?
33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature :
Page 3 of3
DYes 18} No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No ON~ ONE
DYes b?J No DNA ONE
DYes ~No DNA ONE
DYes &No DNA ONE
DYes gNo DNA ONE
Phone: cr/o~3D3-&Iil
Date: G::. -,?--.?o/2
21412 015
Date of Visit: I 7£-/kl Arrival Time:l 5!: 0 0 Departure Time: I /0 .' c:90 I County: .:(_7.3lr'-Region: rK. 0
Farm Name: J-{ Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ().)d.J.t:r A-m m 0?7$ Title:
Onsite Representative: __ _.......:5~~=----==--------------
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
l. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Field
a . Was the conveyance man-made?
D Other:
b. Did the discharge reach waters ofthe State? (If yes, notify DWR)
c . What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: ?r z:-~~
Certification Number: ( 2 79 ;:z_
Certification Number:
Longitude:
0 Yes 8-No DNA ONE
0 Yes 0No DNA ONE
0 Yes 0 No DNA ONE
d. Does the discharge bypass the waste management system? (If yes , notify DWR) 0 Yes 0No DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 o/3
Q Yes fi!.No
Q Yes fil.No
DNA ONE
DNA ONE
21412015 Continued
lFacility Number: z;r-;;..._ ~' f IDate oflnspection: z-f=--Lto
M'aste Collection & Treatment
'f4· Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): /j
Observed Freeboard (in): :3 f
5. Are there any immediate threats to the integrity of any of th e 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 (S¥No 0 NA 0 NE
DYes 0No DNA ONE
Structure 5 Structure 6
DYes f&No DNA ONE
0 Yes !2}No 0 NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental tbreat, notify DWR
7. Do any of the structures need maintenance or improvement?
H. Do any of the s tructures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes l%l.No 0 NA 0 NE
DYes ~No DNA ONE
DYes ~o DNA ONE
DYes ~o DNA ONE
11. Is there evidence of incorrect land application? lfyes, c heck the appropriate box below. 0 Yes ~o 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus D Failure to lncorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12 . Crop Type(s): 137-'//71 If j ~ /JJ-r[v ?'/-< r-ed
13 . Soil Type(s):
14 . Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
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 fac ility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
0 WUP Ochecklists 0 De s ign 0 Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes ~No DNA ONE
0 Yes )29. No DNA ONE
0 Yes BNo DNA ONE
0 Yes .£l No DNA ONE
0 Ye s {81 No DNA ONE
DYes tf8No DNA ONE
0 Yes g) No DNA ONE
O other:
0 Yes tz:j No DNA ONE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analy sis D Waste Transfers 0 Weather Code
D Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Page2of3
DYes ~o DNA ONE
DYes ~No DNA O N E
21412015 Continued
JFacility Nuinber: ''Dd'=-lg (o ( !Date of Inspection: · z--£-.?=>/¥-
24 . Did the facility fail to calibrate waste application equipment as required by the permit? ••
125 . Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes ~No
0 Yes (igNo
DNA ONE
DNA ONE
0 Failure to c omplete annual sludge survey 0 Failure to develop a POA for sludge 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?
2 7. Did the facility fa i l to secure a phosphorus loss assessments (PLAT) certification?
Otber Issues
28 . Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Offi ce 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 additi onal 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?
Revie wer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
0 Yes g) No
DYes ENo
0 Yes (29 No
0 Yes ~No
0 Yes 0,No
DYes ~No
0 Yes £9.-No
0 Yes ~No
DYes ~o
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
Phone: )7o-f?J-53"cn
Date : ?~S;,?t:J/C.
114/2015
Reason for Visit:
Date of Visit: I v ;Jf)jf Arrival Time :I 'j}' /£ I =-Departure Time:l @ .' 13 I County: ~r-Region:
Owner Email: Farm Name: {1 //' AD"? 0/"m~ ;:[;i,t:... r ~ --------------------------------
OwoerName: /<ok;r 5 ~,-{ Phone:
Mailing Address:
Physical Address: -----------------------------------------------------------------------------------
Facility Contact: ~A-m~
Onsite Representative:
Title:----~~=:~<=.:....::....:..:::~~~""~=;...._-­
Integrator:
Phone:
Certified Operator: Certification Number: I 772;?-
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 0-No
Discharge originated at: D Structure D Application Field D Other:
a. Was the conveyance man-made? DYes 0No
b. Did the discharge reach waters of the State? (If yes, notify DWR) DYes 0No
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I ofJ
DYes ~No
DYes ~0
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21411014 Continued
!Facility Number: I Date of Inspection: 1:-I#--r.£1
I
Waste Collection & Treatment
• 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? 0 Yes [E..No 0 NA 0 NE
D Yes 0 No 0 NA D NE a. Jfyes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 1'7
Observed Freeboard (in):
DYes ~o 0NA ONE 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 DYes ~o DNA ONE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threa~ 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 pennit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes _giNo
DYes ~No
DYes ~No
0 Yes 8No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
11. fs there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes g..No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): ;txY~ /12-v-r-r .5t::-~af
13. Soil Type(s): ___ JJ-=...~D......._tf&-._ ___________________________ _
14. Do the receiving crops differ from those designated in theCA WMP?
15 . Does the receiving crop and/or land application s ite need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres detennination?
17. Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste applicat ion 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.
0 WUP 0Checklists 0 Design D Maps 0 Lease Agreements
DYes
D Yes
DYes
DYes
DYes
0 Yes
0 Yes
Oother:
~0 DNA ONE
~No DNA ONE
~No DNA ONE
0No DNA O NE
~No DNA ONE
lj8.No DNA ONE
.[3No DNA ONE
21. Does record keeping need improvement? If ye s, check the appropriate box below. 0 NA D NE DYes jgNo
0 Waste Application 0 Weekly Freeboard 0 Waste Analys is 0 Soil Analysis 0 Waste Transfers 0 Weather Code
0 Rainfall Ostocking 0 C rop Yield 0 12 0 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? O Yes ~ No D NA 0 NE
23 . If selected, did the faci li ty fail to install and mainta in rainbreakers on irrigation equipment? D Yes W, No 0 NA D NE
Page2of3 214/1011 Continued
• !Facility Number: I Date of Inspection: :£-ltt'#8?ift
t •
24 . Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes [BNo
DYes J2No
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List st:ructure(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 rat~s 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)
0 Yes 18 No 0 NA 0 NE
DYes ~No DNA ONE
0 Yes ~ No 0 NA D NE
DYes ~No DNA ONE
0 Yes ~ No 0 NA D NE
0 Yes £;:4 No 0 NA 0 NE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32 . Were any additional problems noted which cause non-compliance of the permit orCA WMP ?
33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Rev iewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
DYes &_No
0 Yes 5aNo
DYes (ilNo
or any
DNA ONE
DNA ONE
DNA ONE
Phone: ?7(J-(£LJ-:r.;roo
Date: 5:-/#'-;,.7t:l/~
2/412011
Date of Visit: I , £/, -1 q I Arrival Time: I I~~ o 0 Departure Timed 1 ~',on I County; ~ fl":":--Region:
FannName:~~C:~~~~u~~~:DD~~v~~~~~~~~~~~~!r:~n~?~·~------Owner Email:
Owner Name: ALrJ-r 2 ct?!.-;--Phone:
Mailing Address:
PhysicalAddress: --------------------------------------------------------------------------------------
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Appli cation Field 0 Other:
a . Was the conveyance man-made?
b. Did the discharge reach waters o f the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: J3"'~6~
Certification Number: (7 Z/b
Certification Number:
Longitude:
DYes ~o DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes
DYes
LiJ.No DNA ONE
(2J-No DNA ONE
21412011 Continued
~ I Facility Number: I Date of Inspection: S-L.-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 1 Structure 2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in): / '"!
Observed Freeboard (in): 3 Y
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 [)lc.No 0 NA 0 NE
DYes 0No DNA ONE
Structure 5 Structure 6
D Yesr~No DNA 0 NE
DYes ~o 0NA 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 pennit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
DYes ~o DNA ONE
DYes ~No DNA ONE
DYes ~o DNA ONE
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes .,[ilNo 0 NA D NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): ~l"rn:uq{ci£.. / VV't'r..$'Cd
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
Page 2 of3
DYes
0 Yes
DYes
DYes
DYes
DYes
DYes
00ther:
DYes
8,No DNA ONE
~No DNA ONE
(2J...No DNA ONE
~No DNA ONE
IEJ No DNA ONE
[3..No DNA ONE
~No DNA ONE
!)a No
2/4/1011 Continued
• IFacili!l: Number: 6C.-t; Lz ( I Date of lns(!ectioo: S-t.>-It.{
{
I
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes (1g..No DNA ONE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes E$No DNA ONE
the appropriate box( es) below.
D Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? DYes E'JNo DNA ONE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes ~No DNA ONE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 0Yes 6lJ No DNA ONE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? DYes 1$-.No DNA ONE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the 0 Yes ~No DNA ONE
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes ~No DNA ONE
D Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes j;2l No DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes 1;21-No DNA ONE
. }::~plain any YES answers and/or any additional recommendations or any other ~"'"'"''~ ... •
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
situations (use additional
Phone: vo-1!.:~-:JJ'UO
Date: ~J~...;;;..b_-...::;;~ __ /1+-
1/4/2011
Date of Visit: I {p -~7-j t Arrival Time: I?! o1>
Farm Name: Carr-Eo v farm.$
I
Owner Name: J< o b '%"' r""t--.5 (_ t!(C
Mailing Address:
Departure Time: I/ a '· cV I County:~~ Region:
Owner Email:
Phone:
Physical Address: ----------------------------------------------------------------------------------
Facility Contact: t.A.tdTr-r A mms,_ -s Phone:
Onsite Representative: ,5~ Integrator: J?cr#!, 1jfe
Certified Operator: Certification Number: /77ll •
Back-up Operator: Certification Number: IY3b'f
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? DYes S.No DNA ONE
Discharge originated at: D Structure D Application Field D Other:
a. Was the conveyance man-made? DYes 0No DNA ONE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No DNA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d . Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes [Sa_ No
DYes [Sa. No
DNA ONE
DNA ONE
11412011 Continued
I Facility Number: I nate of Inspection: b --z-: I 'I
·)yaste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): JCf
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 D NA D NE
Structure 5 Structure 6
D Yes jgl No D NA D NE
DYes &No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8 . Do any of the structures lack adequate markers as required by th e permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste m anagement 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
D Yes l2a. No D NA D NE
DYes ~No DNA ONE
DYes [&1No DNA D NE
II . Is there evidence o f incorrect land application? If yes, check the a ppropriate box below. DYes 1:;8lNo DNA D NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground D Hea_vy Metals (Cu, Zn, etc.)
D PAN D PAN > 10% or 10 lb s. D Total Phosphorus D Failure to Incorporate Manure/S ludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Type(s): 'i$cl"n-tu) ... fttvrr.-,~d
13. Soil Type(s): -4=~"'-.:.A-..:----------------------------------
14 . Do the rec eiving crops differ from those designated in theCA WMP?
15 . Does the receiving c rop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigati on d esign or wettable
acres detemrination?
Pagel of3
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DOther:
DYes
~No
lKl. No
~No
g)_ No
~No
~No
~No
(2g_ No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
114/2011 Continued
rFacility Number: !Dateoflnspection: (a-7-1 ::>
~:J.4. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes ~o DNA ONE
D Yes ~ No 0 NA 0 NE
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Otber Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes [&No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
0 Yes DNA ONE
DYes DNA ONE
DYes DNA ONE
Phone: 2;10 -p:5-J~ar;;::,.
Date: Ia ..-7-d t3
2/4/2011
ompliance Inspection Operation Review 0 Structure Evaluation
Reason for Visit: ~tine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency
Date of Visit: I .¥-/8"'-/2+ Arrival Time:l 9 : ]\l I Departure Time:l I 0 ~ :;ro I County:~<r::--Region: F/2..0
Farm Name: Ca t'r :B t:> '(
Owner Name: 15.. ~ b ~ CT ,S
Fa r m ~ ::c:" c •
Carr:
Owner Email:
Phone:
Mailing Address:
Physical Address: -------------------------------------------
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field
a. Was the conveyance man-made?
0 Other:
b. Did the discharge reach waters of the State? (If yes, notifY DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: ~i-;;; .;.e._
~ p.
Certification Number: / 7 7?-;:L
Certification Number:
Longitude:
DYes !29-No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notifY DWQ) DYes 0No DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes
DYes
~No DNA ONE
(Sa. No DNA ONE
214!201 I Continued
"[Facility Number: IDate of Inspection: £-t~ 12-: 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 Structure2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): I Cf
Observed Freeboard (in): 30
5. Are there any immediate threats to the integrity of any ofthe structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
0 Yes 0 No 0 NA 0 NE
Structure 5 Structure 6
0 Yes 0No DNA ONE
0 Yes l3a_No DNA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes DZt No DNA 0 NE
0 Yes ~Zl.No DNA 0 NE
DYes rgNo DNA ONE
D Yes (g) No 0 NA 0 NE
1 LIs there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes lgj No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): 15-ec.m lb/a.. /ev-<'G~J
13. Soil Type(s):
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres detennination?
1 7. 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.
DYes j3No DNA
DYes ~No DNA
DYes ~No DNA
DYes ~No DNA
DYes li:] No DNA
DYes ~No DNA
DYes ~No DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
OwuP Ochecklists D Design 0 Maps D Lease Agreements 00ther: _________ _
21. Does record keeping need improvement? Ifyes, check the appropriate box below. DYes ~No 0 NA D NE
D Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis D Waste Trans fers 0 Weather Code
D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall In spections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes [81. No 0 NA D NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~No 0 NA D NE
Pagel of3 21412011 Continued
~
!Facility Number: ¥1--&t,t I I nate oflnspection: .£ -t tr-I r
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box( es) below.
0 Yes 00No 0 NA D NE
DYes ~No DNA ONE
D Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? lfyes, check the appropriate box below.
DYes ~No DNA 0 NE
DYes ~No DNA 0 NE
DYes I2J.No 0 NA 0 NE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes li.ZLNo 0 NA D NE
0 Application Field D Lagoon/Storage Pond D Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3of3
DYes ~No
DYes 1){1 No
DYes ~No
DNA ONE
DNA ONE
DNA ONE
Phone: "7TO._Jfj.l-'J3 c;;.
Date: j:-1 ¥'_.. ..:J-o/ ::J-
21412011
'-~~~~~~~--Compliance Inspection
~tine 0
Date of Visit: I ~-U I Arrival Time: I t5'"": .3 0 Departure Time: 19" ~ 1 Q I County: ¥rr--Region: ~ 0
Farm Name: Ca i'C .PV' P'ar"';...,J ~a.::., Owner Email:
Owner Name: R, o b c:c--f-2 e._ <t' c Phone:
Mailing Address:
Phone:
On site Representative:
Certified Operator:
Back-up Operator: Certification Number:
Location of Farm: Latitude:
Discharges and Stream Impacts
l . Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field 0 Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters ofthc State (gallons)?
d . Does the di scharge 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 ob servable adverse impacts or potential adverse impacts to the waters
of the State oth er than fro m a di scharge?
Page I of3
Longitude:
DYes ~No
DYes DNo
DYes 0No
DYes DNo
DYes ~No
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
2141101 I Continued
······
. I Facility Number: rf3": -z; ll I I Date oflnspection: t.. -t:?J.?-/1
Waste CoUection & Treatment
• 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
DYes ~No DNA D NE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any ofthe structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste 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?
~Yes 0No DNA ONE
D Yes ~ No D NA D NE
DYes ~No DNA ONE
D Yes ua No D NA D NE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes U{J No DNA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 Ibs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
I 7. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
DYes !XI No DNA
DYes jlg No DNA
DYes ~No DNA
DYes ~No DNA
DYes l&'J No DNA
DYes ~No DNA
DYes ~No DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
OWUP Ochecklists D Design 0 Maps 0 Lease Agreements Oother: __ ---:-7~------
21. Does record keeping need improvement? If yes, check the appropriate box below. Ji'l. Yes ~-0 NA D NE
IS?J Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis D Waste Transfers 0 Weather Code
0 Rainfall D Stocking 0 Crop Yield D 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 I&J No DNA D NE
23. Ifselec_ted, did the facility fail to install and maintain rainbreakers on irrigation equipment? D Yes jg1 No 0 NA 0 NE
Page2of3 21412011 Continued
• !Facility Number: ~ -/,t,L I Date of Ins~ection: b -;?1.;?--/t_
•
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes [81 No DNA ONE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes
the appropriate box(es) below.
~No DNA ONE
D Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Application Field 0 Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
DYes K}No DNA ONE
DYes U21No DNA ONE
DYes U?J.. No DNA ONE
DYes ~No DNA ONE
DYes !XL No DNA ONE
DYes ~No DNA ONE
DYes IKJ No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
Phone: ~ ..Wz3.3i:rt>
Date: 4:. -;f?Z.?--/1
21411011
.....
0 Structure Evaluation
Reason for Visit 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: I s?o/1-!0I Arrival Time: ll''l.'o 0 I Departure Time: I /0 : 3;;1 County:...,7o---Region: PJ? 0
Farm Name: f2ar~ -:En~ C40?t,t ..:;j:::dt;, Owner Email: -------------
/
OwnerName: "Robc,t= 5 &.,.c Pbone:
Mailing Address: ------------------------------------------
Physical Address:-------------------------------------------
Facility Contact: WaJtf-d: ~ ltm mT:P-Y Title: -------------Phone No: _________ _
Onsite Representative: __ '$""'~""'-=--===-------------Integrator:~~~~
Certified Operator: _____ ... ,~£.::.-.::..1.£,.==---------------Operator Certification Number: I :Z 2£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? 0 Yes IB.No 0 NA ONE
Discharge originated at; 0 Structure 0 Application Field 0 Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons}?
d. 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 impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes [&No DNA ONE
DYes gNo DNA ONE
12128104 Continued
I Facility Number: Q-(,. (,( I Date of Inspection I lr--/1-/ D
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: -------
Spillway?:
Designed Freeboard (in): 19
Observed Freeboard (in): i..(3
5. Are there any immediate threats to the integrity of any of the structures observed?
(ic/ large trees , severe erosion, seepage, etc.)
6 . Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes SNo DNA ONE
DYes 0No DNA. ONE
Structure 5 Structure6
DYes ~0 DNA ONE
DYes JSlNo 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? ~es d 0 NA D NE
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ii!J..No DNA ONE
DYes 13No DNA ONE
DYes ~No DNA ONE
1 I. Is there evidence of incorrect application'! If yes, check the appropriate box below. DYes ~No 0 NA 0 NE
D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn , etc.)
D PAN D PAN > I 0% or 10 lbs 0 Tota l Phosphorus 0 Failure to Incorporate Manure/S ludge into Bare Soil
D Outside of Acceptable C rop Window D Evidence of Wind Drift 0 Application Outside of Area
12 . Crop type(s) &rJ~ /ovrrir;d
13 . Soil type(s) 'fJQ ,A--
14 . Do the receiving crops differ from those dcsi b'llated in the CA WMP? DYes I&J'Io DNA
15. Does the receiving crop and/or land application site need improvement? DYes i)lNo DNA
ONE
ONE
16. Did the facility fail to sec ure and/or operate per the irrigation design or wettable acre determination ? DYes (;! No 0 NA 0 NE
17. Does the facility lack adequate acreage for land application?
18. ls there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 2 of3
DYes ~No DNA ONE
DYes [a. No DNA O NE
Phone:
Date:
11/18104 Continued
·. J Facility Number: &"'J--k-'-£1
"
Date of Inspection W'-11-/() f
Required 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 appropriate box. 0 WUP D Checklists D 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. DYes ~No DNA 0 NE
0 Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Analysis D Wa ste Transfers 0 Annual Certification
D Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYe s ~No DNA ONE
23. If selected, did the facility fail to install and maintain 'rainbreakers on irrigation equipment? DYes 12JNo DNA O N E
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes 15aNo DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes 18]No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes ~No DNA O N E
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 ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document D Yes
and report the mortality rates that were higher than normal?
J2!No DNA ONE
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as require d by DYes DaNo 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? D Yes !»No DNA ONE
Page3 of3 12128104
Co~liance Inspection 0 Operation Review
Reason for Visit e) Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Region:?:JeO DateofVisit: 1$?-@.f ArrivldTime:l/ p:oo I Departure Time: If) rOD I County:~
Farm Name: C~cC J5J?73 P~rm.. ;r=;, £-• Owner Email: -------------
Owner Name: ·(\Db~;'r c~f'"r Phone:
Mailing Address: ------------------------------------------
Physical Address:----:---------------------------------------
Facility Contact: UJ~--thmmer:;::s Title: __________ ___ PboneNo: ________ ___
Onsite Representative: ____ £~~.::;....===------------Integrator: J?r:sz:p~
Certified Operator: -----.=,..S@....ao:Ji::~.o<6--=====---------------Operator Certification Number: / ? 2 'J-.?-
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes .12?J...No DNA ONE
Discharge originated at: D Structure D Application Field D Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 ofthe 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 lijNo DNA ONE
DYes ~No DNA ONE
12128104 Continued
.. I Facility Number: fSl -{p (, ( I O~te of Inspection 1/---ai":Ot
Wnste 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 ?
Stmct ure I S tne cture 2 Structure 3 Structu rt: 4
DYes R}No DNA ONE
DYes DNo DNA ONE
S t ructur\! 5 S tr uctur\! 6
Identifi~r: ------------------------------------
Spillwa y?:
Des igned Freeboard (in): / 9
Observed Freeboard (inJ: 'f /
5. Are there any immediate threats to the integrity of any of the structures observed?
(iell:u&e 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 J4No DNA ONE
If any of questions 4-6 were answered yes, and tbe situation poses an immediate public bealtb or environmental tbreat, notify DWQ
7 . Do any of the structures need maintenance or improvement? !&Yes 0No DNA ONE
8 . Do any of the stuctures lack adequate markers as required by the permit? DYes ~No DNA ONE
(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 DYes JtjNo DNA ONE maintenance or improvement?
Waste Application
10. Are there any required buffers, setbadts, or compliance alternatives that need DYes ~No 0 NA 0 NE
maintenancefUDJ:1rovement?
11 . Is there evideoce of in<:orred applicalion? If yes , cheek tbe appropriate box below. 0 Yes l1a. No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu , Zn , etc.)
0 PAN 0 PAN > 100/o or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s) /Ft-u-.:=d_,..Ye/-
13. Soil type(s)
14. Do the receiving crops differ from those designated in theCA WMP? DYes Ql,No DNA
IS . Does the receiving crop and/or land application site need improvement? DYes .[liNo DNA
16 .. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'iO Yes Df_No DNA
.17. Does the facility lack adequate acreage for land application? DYes 3,No DNA
18. Is there a lack of properly operating waste application equipment? DYes 0-No DNA
~~mmetits (refer to question #): Explain any YES answen and/or any recommendations or any other comments.
·.~~~ driaWings offacility to better explain situations. (use additional pages as necessary):
7. c~~ .... y: Wv..-k.'?-~ 7c~ 15~-
ONE
ONE
ONE
ONE
ONE
.... ._
1-•
Reviewer/Inspector Name c:rr~ {}-v..-/lv-Phone: 9 L Q-t/~'::J.J-3.3° '0
7-.4-rd?oo9 Reviewerllospector Signature: C7~~-Date:
.,, 12128/fU Continued
(
' I Facility Number: V-(, b II Date of Inspection 17:-c:£7-=t::ff
Require-d Records & Documcn1s
19. Did the facility fail to have 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 appropirate box. D WUP 0 Checklists 0 Design 0 Maps D Other
DYes 2SNo DNA ONE
DYes 18lNo DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes [:aNo DNA D NE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? ·DYes l3,No 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 18]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 [5dNo DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes l&'J No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance ofthe permit orCA WMP? DYes 181No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes
and report the mortality rates that were higher than normal?
~No DNA ONE
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes
General Permit? (ie/ discharge, freeboard problems, over application)
~No DNA ONE
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes 0,No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes ®No DNA ONE
Additional Comments and/or Drawings:
....
1--
..._ ..
12128104
0 Operation Review 0 Structure Evaluation
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
r--7--::::;;-::-:;::--:..,...~
Date of Visit: I t7&'D Bf Arrh·al Time: I Jl, S 0 I DepartureTime: 11~1,30 I County: c:5~
Fann Nameo ~~~ D~
Owner Name: __f5._ob. r::cC
Fa~ 01.: r;A"' -Owner EmaU:
G~r Pbone: -------------
MaiUng Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: ....::Wc..=......:aJ:"""--"=i...::;(!:,_"r_fb<---.:m'-'--~o.....:..=-==---_.c.>--Title: ---------Phone No: CJ") D-,.t;{zJ/--L{3j~
Integrator: --J~:;....:~l'_"5£..L~-""7'1=~--------Onsite Representative: ____ .... $~d-t...-<:~i::::!=:::==-----------I ~
Certified Operator: ------.--.:.4~A~~~1~o'-::=:::..._ ________ _ Operator Certification Number:--------
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude: D OD'D"
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? DYes ~No DNA ONE
Discharge originated at: 0 Structure D Application Field 0 Other
a. Was the conveyance man-made? DYes 0No DNA ONE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No DNA ONE
c. What is the estimated volume that reached waters ofthe State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ) DYes DNo DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
DYes 00No
DYes ~No
11/18104
DNA ONE
DNA ONE
Continued
; I Facility Number:&-bCz (I Date of Inspection I z; i7.3':"f3 Y
( Waste Collection & Treatment
• 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. lfyes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes _3No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier:---------------------------------------
Spillway?:
Designed Freeboard (in): __ ...... /_'1:.~.--__ -----------------------------------
Observed Freeboard (in): __ ... ..3~c2<---------------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes i:] 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?
~Yes DNa DNA ONE
DYes !:&No DNA ONE
DYes ~a DNA ONE
DYes ~No DNA ONE
II. Is there evidence of incorrect application? lfyes, check the appropriate box below. DYes l:la.No DNA 0 NE
D Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN D PAN > 10% or 10 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
12. Crop type{s) ~ n1 ~"-/t2e1 c&;-c~J
13. Soil type(s) _...LN~o~7f.!...._ ____________________________ _
14. Do the receiving crops differ from those designated in the CA WMP? DYes
15 . Does the receiving crop and/or land application site need improvement? DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?D Yes
17. Does the facility lack adequate acreage fur land application?
18 . Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page:Zof 3
DYes
DYes
Date:
11118104
~No DNA ONE
Ia No DNA ONE
~0 DNA ONE
~0 DNA ONE
[SlNo DNA ONE
~ I Facility Number: o-tdol Date of Inspection I ~ --¢3--p ;:/'
Required Records & Documents
19. Did the facility fail to have Certificate ofCoverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists D Design D Maps 0 Other
D Yes l2i No D NA D NE
DYes l:»No DNA ONE
21. Does record keeping need improvement? Ifyes, check the appropriate box below. ~Yes 0 No 0 NA 0 NE
~aste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking D 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? DYes m!No DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers 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 a 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 ~0 DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes liwo DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of th e inspection did the facility pose an odor or air quality concern? DYes Rl.No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes (&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 [giNo DNA ONE
33. Does facility require a follow-up visit by same agency? DYes lliNo DNA ONE
Page3 of 3 12128104
Et'l>ivision of Water Quality Sfh;;, __.... · .. I Facility Number I Jl 2;?-_H ~-~( 0 Division of Soil and Water Conservation ?&c.,,;;? : '
•·' .. ·. -...
.. . . -0 Other Agency . , .. :-~1;~~¥~ ',
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~ine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 19'elf:O'} Arrival Time:!//; 0 0 I Departure Time: I /P..'c0 I County: 5¥';,--Region: t=f? 0
FarmName: Cacr J3t>¥ f?!.on1 ..:J;lzc.. OwnerEmail: -------------/
Owner Name: gl!.> b er-r Carr Phone:
Mailing Address: ----------------------------------------
Physic al Address:----------------------------------------
Facility Contact:
Onsite Representative: __ __. ..... ~o<;....;;__;;,_=. __________ _
PhoneNo:_~L----------­
Jntegrator: fi:r¥
Certified Operator: ____ £""-"-~--'--=;;;..._------------Operator Certification Number: t? ~
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD 'D " Longitude: D OD'D"
Des ign Current Design Current Design C~r-:ent .
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population·
ID Wean to Fini sh I I 110 Laver
0 Non-Layer I I 0 Dairy Cow
0 Dairy Calf ' D Dairy Heife1
I
!
D Dry Cow I
D Non-Da iry I
I
D Beef Stocker !
D Beef Feeder •
I
D B eef Brood Cow l
.. -..• -~ ---:=Jl
liSa Wean to Feeder JoOffD srJSJ
D Feeder to F inish
0 Farrow to W can
D Farrow to Feeder
0 Farrow to Finish
D Gilts
D Boars -
Dry Poultry
Other
0 Layers
D Non-Layers
D Pullets
DTurkm
D Turkey Poults
D Other Number of ~tructures; [iJ ID Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? DYes ~No DNA ONE
Discharge originated at: 0 Structure 0 Application Field D Other
a. Was the conveyanc e man -ma de? DYes 0No DNA ONE
b . Did th e di scharge reach waters ofthe State? (If yes, notify DWQ) DYes 0No DNA ONE
c. What is the esti mated volum e that reached waters of the State (gallon s)? I
d. Does discharge bypass the waste management system ? (If yes, notify DWQ)
2. Is there evidence of a pa st discharge from any part of the op erati on?
3. Were there any adverse impac ts or pot e nti a l a dverse impacts to the Waters of th e State
other than from a discharge?
DYes 0No
DYes (g!No
D Yes IKNo
12128/04
DNA ONE
DNA ONE
D NA O NE
Continued
I Facility Number: }2--{,&fl Date of Inspection 19:f;flJf-!f>o7
Waste CoUection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into th e structural fre eboard?
Structure I Structure 2 Structure 3 Structure 4
DYes ~No DNA ONE
DYes DNo DNA ONE
Structure 5 Structure 6
Identifier :-----------------------------------------
Spillway?:
DesigncdFreeboard(in): __ ,_fl.....:,.. _________________________________ _
Observed Freeboard (in): _ ___,3-........;~'-----------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large tree s, severe erosion, seepage, etc.)
DYes IXINo DNA ONE
6. Are t here structures on-site which are not properly addresse d and/or managed
through a waste management or closure plan?
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public bealtb or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improve ment?
8. Do any of the stuctures la ck adequate markers as required by the permit?
(Not applicable to roofed pits , dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures requi re
maintenance or improve ment?
Waste Apolication
10. Are there any required buffers, setbacks , or compliance alternatives that need
maintenance/improvement?
~Yes DNo DNA ONE
DYes ~No DNA ONE
DYes 12!1No DNA ONE
0 Yes 12J.No DNA 0 NE
II . Is there evidence of incorrect appli ca tion? If yes, c heck the appropriate box below. D Ye s ~No D NA D NE
0 Excessive Ponding D Hydraulic Overl oa d 0 Frozen Ground 0 Heavy Met a ls (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs 0 Total Phosphorus 0 Fai lure to Incorp orate Manure/Sludge into Bare Soil
0 Outside of Acceptab le Crop Window D Ev idence of Wind Drift D Application Outside of Area
12. Crop type(s) &emu)._ / fJv--e<s~z:-J
13 . So il type(s) --~.!J~·;..::o::.Jtl:L:,_ __________________________ _
14 . Do th e receiving crops differ fro m those d es ignated in theCA WMP ? D Yes 181No DNA ONE
15. Does the receiving crop and/or lan d app licat ion s ite need improvement? DYes ~No DNA ONE
16. Did the facility fail to secure and/or operate per the irrigati on design or wettable acre detennination?D Y es ~No DNA O NE
17. Does the facility lack adequate acreage for land app lication? DYes !I?No DNA ONE
18. Is there a lack o f properly operating waste appli cation equi pment? D Yes ~No DNA O NE
Comments (refer t o 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):
t?~~r' ()l&r~:y-~~~J , M.s-n~ ~~F~~~ ~~ ...
f.-
[)~fief<-s;-J e ..rf-j/1-;P,
1-•
Reviewer/Inspector Name 5/?t-<t . ~?E-~ Phone: 91 I)-7'J.J-:53 pt)
R eviewer/Ins p ector Signature: ~_J .d/-• Date: 9-.:P¢"-~07
12/28104 Co ntinued
., . .... ~ .· ..
I Facility Number: s;).. -Je(o 11
Required Records & Documents
Date of Inspection lq-(J1ij-op
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Docs the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps D Other
DYes ~No DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? lfyes, check the appropriate box below. DYes ~No DNA 0 NE
0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Annual Certification
D Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE
23. If selected, did the facility fail t'? install and maintain rain breakers on irrigation equipment? DYes 00No DNA D·NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes liSI No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes [:krNo 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 i&fNo DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes 181No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes ~No DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes 181No 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 Q9No DNA ONE
Additional Comments and/or Drawings: ...
t--
1--...
]2/28104
\ •, I
.£ . • 1 .
Type of Visit ~ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit «.utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
OateofVisit: I (,-t?J-()(, I Arrival Timed 9! /0 I Departure Time: l/O!trD I County: ~$C"'-Region: rJ5 0
FarmName: Cacc A'n~ Pal'm,:, .;F;'n~· , Owner Em a il : -------------
Owner Name: R <2 h >-cL ' ....;Ca=:..:~"'-!r~·-------Phone:
Mailing Address: c90 I T 1,!-r'Aa.. henu k Tro: L
Phys ical Address:----------------------------------------
Facility Contact: _.:....W.....:tL=~i..L..!:...~.!....;____;;;.S-.ulfwm~mt.!..!...!o~n~;.s:._Title : ---------Phone No:---------
Integrator: ,ffr'P ~z= Onsite Representative: ___ 1'~~:......::..:;;.-=-----------
Certified Operator: ----~.:iii:::=-==--------------Operator Certification Number: I 2 2 9,;z.__
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude: D o o~ D "
Discharges & Stream Impacts
I. Is any di scharge o bserve d from any part of the operation?
Di scharge o ri gin ated at: 0 Structure 0 Applicati on Field 0 Other
a. Wa s the conveyance man-made?
b . Did the di sc harge reac h wa te rs of th e Stat e'! (I f ye s, notifY DW Q)
c. Wh at is th e estimate d vo lu me tha t re ache d wate rs o f th e State (ga llo ns)?
d . Does di scharge bypass th e w aste ma nageme nt syste m? (I f yes, not ify DWQ)
2. Is th ere evide nce of a past di scharge from any part of the operatio n'?
3. We re there a ny a dve rse imp ac t s or po tent ia l adve rs e im pacts to the Waters of th e State
oth er th an from a discharge?
Page I of3
D Yes PfNo DNA O NE
DYes ~N o DNA ONE
DYes IlL N o DNA O NE
D Yes ~No DNA ONE
DYes g[No DNA ONE
D Yes [&No DNA O NE
/1118104 Continued
iffitt '' I it w·ret.t tft· ·¢ -~--ww0it b * *~·-~.:~.·.;.,
, . I Facility Number: e -~b ( I Date of Inspection I ? -£.-QC:, I
f
'
~Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste lev~! into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes ~No DNA ONE
0 Yes ti?J.No DNA 0 NE
Structure 5 Structure 6
Identifier:---------------------------------------
Spillway?:
Designed Freeboard (in): _ ___,c,/____.9:....._ __ ------------------------------
Observed Freeboard (in): ~c;...d-~~~bc;;;: ___ --------------------------------
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 1:8.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? 0 Yes Ill No DNA 0 NE
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management 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 gjNo DNA ONE
DYes ~No DNA ONE
0 Yes ~No DNA ONE
II. Is th ere evidence of incorrect application? If yes , check the appropriate box below. D Yes (la No D NA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metal s (Cu, Z n, etc.)
0 PAN D PAN > 10% or 10 lb s 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable C rop Window 0 Evidence of Wind Drift 0 Application Outside of Area
13 . Soil type(s)
14. Do the receivin g crops differ from those designated in theCA WMP? DYes
15. Does the receiving crop and/or land application site need improveme nt? DYes
16. Did the fa cility fail to secure and/or operate per the irrigation design or wettable acre detennination!D Yes
17. Does the fa c il ity lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewe r/Inspector Sig nature:
DYes
DYes
Date:
12128104
~No DNA
.iQ No DNA
[Ja.No DNA
~No DNA
~No DNA
ONE
ONE
ONE
ONE
ONE
I Facility Number: k.¢., -lz{z tl Date of Inspection I Z -t? -D ~~
, Required 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. D WUP D Checklists D Design D Maps 0 Other
DYes ,KJNo DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? lfyes, check the appropriate box below. 0 Yes ~No 0 NA D NE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers D Annual Certification
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections D Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance 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
12128104
~No DNA ONE
~No DNA ONE
~No DNA ONE
IJCl. No DNA ONE
!llNo DNA ONE
liJ. No DNA ONE
~No DNA ONE
~No DNA ONE
RJNo DNA ONE
{X1No DNA ONE
~No DNA ONE
DQNo DNA ONE
' e Division of Water Quality· ,
· O .Division ofSoil and WaterConsenation
er 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 D Denied Access
Date of Visit: J S: 2'J·DS""I Arrh·al Timed Jo; oo-I Departure Time: LJ ___ __.I County: _..)~¥.5•~ Region: 80
Farm Name: -~_,....., &,.,., ' -r-~ ~~--~-~~~·-~---~~~~------------Owner Email: --------------
Owner Name: ---~tf--\..D 6e,.+ Phone:
Mailing Address: ~ O/ fe,..,g_hQ..~~:f._ ______ _
Ph~·sical Address:-----------------------------------------
Facility Contact: ______________ Titll.': PhoneNo: ________ _
On site Representative: __ 1(.'--'-"D'-=k~~!...f __ ....:::;~:::.tu~··-r:....l-rL~~ ... ~~.I.J,#.~j--Integrator: I' r~s~_,7.._t-_________ _
Certified Operator: __ __.:,/l,_,dk=~'..~.f ____ t4,...r;;.o:c~-------
Back-up Operator: ---....:~'----_ ___;.,4..:...:..,..'-""'~__,::L_.._ ____ _
Operator Certification Number: _1.::;8.""'.1:.='-;...Xr----~
Back-up Certification Number: -=-'..!.?_7L9..IA~II!:1-----
Location ofFarm: Latitude: D OD'D" Longitude: D OD'D"
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
I I I' 10 Layer 1. 1.: ~[]~N~_o~n~-~L~~Y~. e~r--~------~· ~~~~·.
ID Wean to Finish
[id1V ean to F eedcr l&oeo (, t:J "1 S""'
0 Feeder to Finish
0 Farrow to Wean
[]Farrow to Feeder
[]Farrow to Finish
0 Gilts
D Boars
,. ---·-·
Dry Poultry
0 DairvCow
I
I
0 Dairv Calf I 0 Dairy Heifer I
0 Dry Cow I 0 Non-Dairy
0 Beef Stocker
I
I 0 BeefFeeder
0 Beef Brood Cow J ------
0 Layers
0 Non-Layers
0 Pullets I
D Turkeys
Other 0 Turkey Poults
0 Other
·-
Number of Structures: OJ [ JD Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes ~ DNA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other
a. Was the conveyance man-made? DYes 0No DNA ONE
b. Did the discharge reach waters of the State'? (lfyes. notify DWQ) DYes 0No DNA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part 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
DYes ~
DYes ~0
12128104
DNA ONE
DNA ONE
DNA ONE
Continued
I Facility Number: {j.< -(, c, ( Date of Inspection
Waste CoUectioo & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 2 Structure 3 Structure 4
'•
Observed Freeboard (in): 3 s-~
DYes ~o DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any ofthe structures observed? DYes 13"No 0 NA 0 NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed 0 Yes 13"N"o D NA 0 NE
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? DYes ~o DNA D NE
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
0 Yes G3"No DNA D NE
DYes !ZrNo DNA 0 NE
DYes G?No DNA ONE
II. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes !:&'No DNA 0 NE
D Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn , etc.)
D PAN D PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
12. Crop type(s) ~(3u.,.~rt:..!!lML.~ov~~'LJ12a ________________________________ _
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? DYes
15. Does the receiving crop and/or land application site need improvement? DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination! D Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/lnsp~tor Signature:
DYes
DYes
Date:
12128104
0'No DNA ONE
~ ,..,.,IJ
DNA~'
0No DNA ~
0No DNA B'NE
[;HGo DNA ONE
Continued
j Facility Number: 8:2 -U (
Required Records & Documents
Date of Inspection I £·:1?-o.S: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? lfyes, check
the appropirate box. D ~ D c~ D ~ D ~ D Other
21. Does record keeping need improvement? If yes, check the appr;priate box belo~
DYes ~o DNA ONE
DYes ~o DNA ONE
DYes Q.No DNA ONE
tr·t~~ :2 ·~ ~ • .!../?·.) /. s 0 Waste Appticatffin 0 U/t~eltl, Frccboaid 0 Waste Analysis U ~ Aiialysts 0 Wwtc TJansfcJs D Atmual CCitiT;estign
0 B aiRfal~ 0 ~g 0 Crop Yield 0 Htl Minute lnspectieAS D M6nthiy and I" Rain ltt!peetiens D We!Hfter Cede
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
11118104
~0 DNA ONE
0No D NA ~
0No DNA g.m;
0No DNA [iJ..M£
DNo DNA ~
0No DNA ~
~0 DNA ONE
l3"No DNA ONE
[31.lo DNA ONE
G"No DNA ONE
0'No DNA ONE
12!'No DNA ONE
Type of Visit e Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Vi sit 8 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access
Facility !\umber 1 8;;1 H Z ' I 1 ! Date ,,'f \"isit: I '/l,;t/tJY I Time: I /.' /0 "'--------------------.-J! fO 1\"ot Operational 0 Below Threshold
EJ Permitted Ill Certified [J Conditionan~· Certified [J Regi~tered Date Last Operated or Abo,·e Threshold:
Farm!\ame; cell ...... Bo1 F~.,...~ T r'\~. County: $ e,., p Sc.#J F leO
Owner Name; Q ob c•~ .......JC-..~o~r ..... r'----------Phone !'io: {5 ~~~ S9.:J -:J~7 ¥
l\lailing Address: :2 0 I To ens L o..., k L s ; I C J.·~.fo&J N C .;J8.3~f
Facilif)· Contact: t.J~ tlc.e flMmo¥..J Title: -----------Phone No: ~ '0 ) S~~-l.f31S
Onsite Representative : _ ..... /u......._=a~f.:....'-tt....e=.rt....-_c..:t:l~m:.r;.L.OfO"'':;;..:"..!Dal":.:...zt:..__ ____ _ Integrator: _-L.&.L...:.cli.....A., ..... +~o!oUOlju':;...._..::h_4~,...L,....::!...o!.,~'----
Certified Operator: tc!~/lelll! Operator Certification .Number: d /77'2.
Location of Farm:
lJ Swine 0 Poultry D Cattle D Horse Latitude ...___....JI•~..-1 _ ___.!• ._I __ ....JI" Longitude .__~I· ._I _ ..... I· ._I _ ....... ! ..
Design Current Design Current Design Current
Swine Capacitv Population Poultry Cal!acm· Pol!ulatiou Cattle Cal!acin· Pol!ulatiou
[]!Wean to Feeder 'tJ s~ t. oSi:J Po ~::~Laver I I I IODairv I I I 0 Feeder to Finish :o Non-Dairv :
] Farrow to Wean ID Other I I D Farrow to Feeder I
D Farrow to Finish
, I I Total Design Capacity
D Gilts I I 0Boars Total SSLW
Number ofi.Jti:oons I I I ID Subsurface Drains Present ~0 La2oon Area ID sl!"''" Field Area I
. Holding Ponds I Solid Traps I I ID l'io Liguid Waste Management s,·stem
Discbar<>es & Stream Impacts
!. Is any discharge observed from any pan of the operation?
Discharge originated at: 0 Lae:oon 0 Spray Field D Other
a. If discharge is observed, was the conveyance man-made?
b. lf discharge is obser.-ed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gaUmin?
d. Does discharge, bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any pan of the operation?
I
3 . Were there any adverse impacts or potential adverse impaCtS to the Waters of the State other than from a discharge?
Wase Collection & Treanneut
4 . Is storage capacity (freeboard plus storm storage) less than adequate?
Identifier:
Freeboard (inches):
05103101
Strucrure 1 Structure 2 Structure 3
t
.33 ,,
0 Spillway
Structure 4 Structure 5
.. .
.• .. . ..
DYes [XI No
DYes 0No
DYes 0No
N{/1
DYes 0No
DYes [}No
DYes !!No
DYes [lNo
Structure 6
Continued
•I Fadli(y Number: 8 ~ Date of Inspection 1"?/ .. u/WJ
5. Are there any immediate threats to the integrity of an y of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6 . Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the strucnues need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any sructures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
\Vaste Aoplication
10. Are there any buffers that need maintenance/improvement?
II. Is there evidence of over application? D Excessi ve Pending
12. Crop type
J
0 PAN 0 H ydraulic Overload
( R1 e.)
13. Do the recei ving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment'?
Reguired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to h ave all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists , design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design ?
21. Did the facility fail to have a actively cenified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by Gene ral Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
24. Does facility require a follow-up visit by same agenc y?
25. Were an y additional problems noted which cause noncompliance of the Certified A 'WMP?
DYes
DYes
Ill Yes
DYes
DYes
DYes
DYes
DYes
DYes
D Yes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
IC ~o violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
rnu.rfcl"£ i~ .,..."c.. ~<r,..w..~~ C:t"or t...J,'/1
7-Plt!4Jt!. i-~IM-'-'tiC.:.. -fr~c~ ~ .. ae_ fA~ol~r·p·o~/...
CoAJf/AJuC::. --fo t<V'o,-1<.. o;-. la.'j~'(l.v h4rc_
Reviewer/Inspector Name
Re~iewerllnspector Signature:
b ~ .Sf',.d1 c&?... w ~-~ 1'1Ji<:j•
+ "' ..,.-1... ~ +~ c. 0 .f: +-k <.. a~; k <. •
Jpe>t.s.
Date:
IXJNo
ljJNo
0No
~No
ij(l No
I]) No
[]I No
[IJNo
ij]No
(iJNo
lXI No
CJNo
[l)No
Ill No
[!JNo
[i)No
[J]No
l11No
liJNo
[i] No
([]No
Ill No
05103101 Continued
lnfonnation contained in this database is from non agency sources and is considered unconr1rmea.
Animal Operation's Telephone Log
DWQ Facility Number [g) -l(,b I I
Farm Name jCARRBOY FARMS
caller's Name IWAL TER AMMONS
l® Reporting 0 Complaint
caue(s Phone t#
Access to Fann
Farm Accessible
from main road IO Yes 0 No
Animal Population
Confined lOVes ONo
Depop JOYes QNo
Feed Available loves QNo
Mortality joves ONo
Spray Availability
Pumping r.:~=----=~~
Equipment IO Yes 0 No
A~':t~ lo Yes 0 No
La~:oon Questions
Breached lOVes
Inundated JOVes
Overtopped IOYes
Water on lOVes outside wan
Dike Conditions IOYes
Freeboard Level
Freeboard
Date
Time
Control Number L-117_4_2 __ ~
Region L.IF_Ro __ ___..
ONo
ONo
ONo
ONo
ONo
Plan Due Date Date Plan Date Freeboard
Inches (? equals blank) Received Level OK
L.agoon1 18.5 I
L.agoon2 ~
Lagoon3 ~
Lagoon4 ~
LagoonS E
Lagoon& ~
--------· --------------------------~------------
.. L -..._---------L T ---• ------------
EN:T.EREO.BY..P.AULRAWLS ..................................................................................................................................................... .
----------------------------------------------------------------------
•••••••u ••••---• •~•• .. ••• ••••••••• .,,.., .. ,.. .. •••••••••••••u-• ••••u ••• ••••••-•••••u•••••••u•u ••••••-••••-u••••••••• ••• ••••••••• ••••-•--••••--••••-•••••••-•••• .. -••••---••••--••-•-•
-------------------·---------------------------------------------------
-··--····----·--····-··--·············---·············--······--····-·················-···· ... ···-···---·---··--·--------·--·-···-··--·---··-··--·····----------------· ----------------------------------------------------------------------. -· ....... -·· .... -·· .................. ---·· ..... -·· ...................... ···-·· .................... •··•·· ................. -··-·· -·· ................. ---· -···· -·· ....... -· _ .............. -·· ................... ···-·· ...... -·· ... -·· ... .
•••••..,•••••••M-•-•-••••••••••••••·ou e-•••••••U•••••••u•••••-•••••••-••••-u •..,•-•• ... -••••..,•••••••..,•-••••-••••-•••-••••-••-uo••••u••·••••-••••••••-n•o-•--••-••••-•••-•-·--....,w••••-•u•--·~-••...,•-•••-••-·-·--·---•-••••-•
--------··-------------------------------------------------------------
••••u•u •••••u•-o.oeo.ueueuee•-••••••••••u •••••••••-•••••••••••••••••u•••-• oeeouoo•-•-•oea••••••••a..,a••••eeUeu••u•••••••••••o&eeueeeooooo•• ••••••••••••••• •••••••••u•••••••••••·•-•••e••--•••••-••••••••••••••••••••••••••••••--•-·•-•••••••••••••••••••
,... _____ ._~
• --------------------___,j"--..:.--------·· -.
----~
Date otlaspedloD I ·,.adllty Namber I p. Ht6-C/ L . :,_
11me Gf IDsped'oD I 3 ~ffYC> I OR 241ar. Clme
FumStldas: e~t'.~~/ Total Tllllt (Ia laoan) Speat oDitnlew I Z-fu I
or l.aspecdoa (IDdades tnwl ud processiD&)
FanaName: Ce~ 1GeJ ~r -~c.. eoutr. ~zr-'_nn-)
oW.er~ &M&f: &-&& PJmaeNo: (ttC:)s$0:72-27' ??/
Malliq.Addrea: /PJ £,v'y-~ 51;. et~~,j /t)C ;z_fs 2£
Olllheltlp~dft: 4/4:/~ ~~cr-f' JatepatDl: ~~A~
Cercl&d()pentm; p~ 4-e: ~--o;V.r-OpeaamCerdflcatloDNamber: I?? Z:Z.
Locadoa of Farm:
I&% 0t se<4 b#"!4-·"_.u&,..-~w,~7 u~¢~1J
IAIIIodo I 1•1 1·1 I• I.eaabde 11•1 H l~;;;;.t. ......... ~?u.-..._
.ID Not Operatioaal I Date Lat Operated: .
Cpm1
1. Aze lbtre ay buffers tbat Deed maiatezvmcd"wwzo9'CIDC:DI?
2. Is ay clischarp obscrwd fram aJrf pan of die ooealicm?
~ If cfischap is obsa ved. W1S abe CIOJIVe)'8DCe IJ18IHDidc?
b. Jf cl.ischlrp is observed. did it n:acb SurfAce Wau:il (Jfyes. DGCify DWQ)
c. lf disc:barBe is observed, what il dle estimeted flow iD pi/miD?
r
d.. Does discbarae bypass a lagoon system? (If yes. Dobfy DWQ)
3 . Is lbcre eviclcDce of past disc:harp fiam uy p1rt of die opcraicm?
4. Wu dmc any adYase implca to abe wasers oflbe Scatc other thaD 6vm a ditcblrJe?
j. Doa ay pan of tbe waste maapmcm aystaD (Oibcr dum JaaooulboldiD& pcmds) nqujre
· · · IDiintcDIDcefDDDiovement7
DYes )aNo
eves ~0
CYes )INo c~J
[]Yes fJfNo
~.5
0Yes. JINo
CYes }INo
0Yes []No
[]Yes ~No
--.. ------· ---.. ---·-----······----
. -
6. k kilily DDt iD comptiace with 1111)' applicable ledllct aill:ria?
1. Di4 tbc facility fail tD haft a cadfied opeMDi iD rapowibJe dulrp (If illlpectiGD after 111N1)?
-8. Ale Cbcft Jasoaqs or atorqe poDds em Iitle wbidl Deed tD be puperly dosecJ?
S!nctam lLagoons agfor RoJdln lo!dsl
9. k suuetural&ecboatd Ita Ibm ldcqualr?
FsDoad(ft): . I~ 1
?6~
10. k P'Cp'lp obsa ved fivm my of the llnK2UI'CI?
11. k c:osicm, or ay GCbcr 1brcab co tbe mtqpity ot IDY ottbe mucsura obtcrved"!
12. Do Ill)' of the ltNdUres need maintaunu!improvaDeiJ!?
(If uy of qoatloas 9-ll was aaswered yes. ud the dtuadoa poses u
immediate pablk bealdl or aviroameatal tbrat, DOdfy DWQ)
-.
13. Do IDY of lbc stn1CCUres Jack lldquate markers 10 idaztify llllt mdaop pumping levels?
Wam Appligdon
OY~ ~No
CYes 'No
DYes ~o
DYes ~No
Llaooa4
CYe:s Js{No
DYes .lf'No
D(ves []No
[JYcs~No
.; . . .
J4. Is tbm physical evideuce of over applicalicm? [J Yes .J!(No· .
_(If ill exeess ofWMP. or nmoff CDtaiDg wasas of tbc Slate, DGtify DWQ)
15. Qop cype 6v ..... h /.:ch:,/r qMr,J I t-
16. Do the active crops dift'erwith those daipalrd iD the A.Dimal Wute MaDqemmt PliD? ·
'
17. Does tbc facility have a Jack of adequate acrcaae for lmd application?
11. Does the cover crop DCed improvaDalt?
19. Is there a lack of available irrigation equipmatt?
for C~r!tfied FacOitiet OpJv
.20. Docs cbe facility &i110 have a copy ofdle ADimaJ Waste Managemem PJID radiJy available?
21. Docs cbe facility &i1 to comply wilb the ADimal Wa.ue Meaaematt Pta ill ay way?
.22. Does t=mf beping DCCd .iqnovrm=t?
23. Does facility nqWre a follow•11J' mit by 11DDC aaaq1
24 . Did Rnicwer/lnsptdOT fiW to discuss rcviewfmspecticm widJ OWDCr ar opuatot iD duqe?
[JYes ;il,No
[JYes ~
DYes ~o
CYcs ,ltNo
\ CYes~o
. )(Yes CNo
DYes iQNo
[JYcs JQNo
DYes Pii-No
~~:(refct: .o·quCisr:iOo #):: £xPlam any YES lllswai"udloiifity. reeomm~oiis or -.v Olber.eouixzaars.:: ... :.._~~,.-:/;.;;::--:-;; ... : _. .. :. :~: ... :_.: ·-~· use"~...;·or~~,~ .obdsd ·mllin;&itui:tiOU-~use -~~-1e:s ·.s~aeceulrV'~;~~~b.~~--:-;~~~.# ~·::. ;:....,~;,r.;-?,F~::+ :.(:, .::·. · . :~~~~--.. •~-~3·.,, ... , ... , ....... ~r ............. -~"~-\.,. .... -... _ .......... ~ ..... ;..r..~. _ .. .,. ...... ~>-c ....... __ ,,":J:.I•t:IICit ~~~~;t .~ ''.·.:·.·-~· ·• ,.. .. _ .. _ ... "'·--.. _tlt/..1
tz ~£~ ,E'~~_,j,L' ,tii? C?~;/,£,<:. f'L'.#S""/ A'£1P.t..-/~~.....> c~~/~.s
:z/. ~c;h~ (4,4 r ~"*·-r>"~J. ~~ ~ ~~ ./$#'bJ d~ 14 ~r,.J ,;tt/~
~ /_fr""'"f /_, ~b /1) -,J'FP..
1 1q-'?6 V
Rnkwernaspecmr Name f· ·:,_~· ;;-~~~:-.~~t~~-,-~~~~~~~ §· .~.--~.-~-~-7~:t .... ~ . ....:-V-.~!:~ir~;r-~:rf.;t[;_.:2:-,:Z,~
Revtwft'I1DJptdOr Slpatare: