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HomeMy WebLinkAbout820664_INSPECTIONS_20171231NORTH CAROLINA Department of Environmental Quality Technical Assistance 0 Denied Access Date of Visit: l2bk?r!ft Arrival Time: I/ 0 ! cjS Farm Name: G,..,' n'lr(5 't;D~ ~ l'"f11-. Departure Timed / / .' DD I County:. ¥'"-Region: £7'tJ Owner Email: Owner Name: tfu,.-f!P-\-L Gt'~YH"'C".j Phone: Mailing Address: ----------------------------------------- Physical Address: Facility Contact: ~~/" ~r-c._ Onsite Representative: -"""'''-<;;..-t=~=-=:;....;;=---------------Integrator: Pbooe: dff1i2 I ~ d /.o,-~7'7qc.. ~eT' Certified Operator: Certification Number: J t?l:> /£74 • Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts I. Is any di sc harge observed from any part of the operation? DY es ~ DNA ONE Discharge originated at: 0 Structure 0 Application Field 0 Other: a. Was the conveyance man-made? 0 Yes 0No DNA ONE b. Did the discharge reach waters of the State? (If yes, notifY DWR) 0 Yes 0No DNA ONE c. What is the estimated volume that reached waters of the State (gallons)? d . Does the di scharge bypass the waste management system? (If yes, notifY DWR) DYes 0No DNA ONE 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page I of3 DYes 0 Yes r:(N'o DNA ONE ~0 DNA ONE 2/4/1015 Continued ,jFacill!y Number: @' -!; fPtf Waste Collection & Treatment loateoflnspection: /O;-cilo-t$t' ; 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 l Structure 2 Structure 3 Structure 4 Identifier: C.ot..V-r l'DP Spillway?: Designed Freeboard (in): 1'7 lCf Observed Freeboard (in): 40 3J..- 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? QYes ~ DNA ONE 0 Yes 0No D NA ONE Structure 5 Structure 6 DYes~ DNA ONE DYes~ DNA ONE If any of questions 4-6 were answered yes., and the situation poses an immediate public health or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the 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 0 Yes EfN'o DNA ONE ~DNA ONE DYes ~o DNA O NE 0 Yes DNA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~0 ~0 D NA ONE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metal s (Cu, Zn, etc.) 0 PAN 0 PAN > I 0% or I 0 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 App li cation Outside of Approved Area 12. Crop Type(s): J5~4L ~~7~,-J 13 . Soi l Type(s): ~vl/)-c- 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 availabl e? Jfyes, check the appropriate box. Owup O checklists 0 Design 0 Maps 0 Lease Agreements 21. Does record keeping need improve ment? If yes, check the appropriate box below. DYes~ 0 Yes 0'No DYes ~o DYes EfN'o DYes ~0 0 Yes [311o 0 Yes ~ 0 0ther: DYes ~ DNA ONE D NA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 0 Waste Appli cation 0 Weekl y Freeboard D Waste Anal ysis D Soi l Anal ysis D Waste Transfers 0 Weather Code 0 Rainfall 0Stocking 0 Crop Yield 01 20 Minute Inspections 0 Monthl y and 1" Rainfall Inspections Osludge Survey 22 . Did the fac ili ty fail to install and maintain a rain gauge? 0 Yes ~o D NA D NE 23. If selected, did the facility fail to install a nd maintain rainbreakers on irrigation equipment? 0 Yes ~ DNA 0 NE Poge2of3 11411015 Continued •!Facility Number: ft? -z;z;q I IDateoflospection: /1J -,J{~~ : 24. Did the facility fail to calibrate waste application equipment as required by the pennit? 0 Yes ~ 0 NA 0 NE t 25. Is the facility out of compliance with pennit conditions related to sludge? If yes, check 0 Yes [a--No 0 NA 0 NE the appropriate box(es) below. 0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the pennit? (i.e., discharge, freeboard problems, over-application) 31 . Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Application Field 0 Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the pennit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? firrm ~~~7/-~ 11;yJ ~1,-wJ. f?CJ/1-~z::-c I v r). ?>r#l.. t~3 {./..J'"Y c 3 ~ +-; _) _ _!, 7'"; w-(D _s?j; .....-.. p() ft. ~~/c ~ ..-'\.. c.~~L:~c 'r::: o/ /O-J?-/~ A>-o¥,.-d-,....... ~<.<.)----1-~ af.-= wde-r 7 ~ 1-;Jf)--. (jfXP''-6'Pr~/ :i/v -c Jy ~c . c9£>/~ ~---~-b ,~~ J:;/ J,( ~ 6 j/ Dec . cP/> 1~ ~ -r-co-n6 7-~.i~.,.....oyz,/ I J-t,--/t)/~ Reviewer/Inspector Name: Reviewer/Ins pector Signature: Page 3 of3 0 Yes c:rNo DNA ONE DYes [3"No DNA ONE DYes [;3'-No DNA ONE DYes £2rN'o DNA ONE DYes [61ifo DNA ONE DYes ~0 DNA ONE DYes 12J"No DNA ONE DYes c;31'io DNA ONE DYes @No DNA ONE Phone: 9--tD .:3 iJ :3-iJt,S-(. Date: /Z).-~ 214120 15 Reason for Visit: 0 Other 0 Denied Access Date of Visit: llt2::&;)lf17Arrival Time:l,/.0 /3 0 Departure Time: l!d.'JO I County: ~0"""'---Region: r/( lJ Farm Name: Gr:; m..,..1 J<?;J .;;r,..._ Owner Email: Owner Name: Phone: Mailing Address: Physical Address: Facility Contact: ___,G ...... ,_t ..:;;r. .... c:...,_ r-.__-..<...:Jn;..;.:;o,~l>'"'f...::C...=----Title: Phone: Onsite Representative: Integrator: Certified Operator: -..t~"""'C---'z:::""'_;.;..j_' :..;I ~;...;;;:.._..;Q3=.:~:.....;...r' .~o.r..;>_'=.:...;t:t?::...;i ______ _ Certification Number: /D'D !..:S'l1 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 ~o Discharge originated at: 0 Structure 0 Application Field 0 Other: a. Was the conveyance man-made? 0 Yes 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 disc harge bypass the waste management system? (If yes, notify DWR) DYes 0No 2 . Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or po tential adverse impacts to the waters of the State other than from a discharge? Page I of3 DYes ba,_No OY~s ~0 DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 114/2015 Continued , !Facility Number: 4 -/..t(,L{ Waste Collection & Treatment loateoflnspection: to-J't-17 I ~ 4 . Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard ? Structure I Structure 2 Structure 3 Structure 4 Identifier: t.tZ.u.Jer "Jqz_ Spillway?: Designed Freeboard (in): L9:. L9 Observed Freeboard (in): ~7 37 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e ., large trees, severe erosion, seepage, etc .) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes QNo DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 0 Yes ~No 0 NA ONE DYes ~No DNA ONE If any of questions 4-6 were answered yes, and tbe situation poses an immediate public health or environmental tbreat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10 . Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? ~Yes D No 0 NA D NE ~._Yes D No 0 NA 0 NE 0 Yes f:il._No 0 NA D NE DYes ~No DNA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes @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/S ludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12 . Crop Type(s): :J3rra~ /pvt=C"$r;:!"r-J 13 . Soil Type(s): $h;v-J/..c 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 irri gation design or wettable acres determination? 17 . Does the facility lack adequate acreage for land application? 18 . Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. D WUP Ochecklists 0 Design 0 Maps 0 Lease Agreements 21 . Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes D Yes D Yes 0 Yes 0 Yes 0 Yes D Yes Oother: 0 Yes ~No DNA ONE ~No DNA ONE ~No DNA ONE 12J_No DNA ONE ~No DNA ONE ~No DNA ONE ~No DNA ONE ~No DNA ONE D Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Anal ys is 0 Waste Transfers 0 Weather Code D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall In spect ions 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~ No 0 NA D NE 23 .1fselected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes {8 No 0 NA D NE Page 1 of3 114/1015 Continued ·I Facility Number: 'f2= -k ht{ loate of Inspection: to-J?-1 7 t 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No QNA ONE D Yes 9_No D NA D NE • 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 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 exist at the facility? If yes, check the appropriate box below. 0 Application Field D Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit 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? DYes ~No DYes [2J.No DYes ~No DYes ~No DYes ~No 0 Yes [2J.No DYes ~No DYes fi] No DYes ~o DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE ,_,wrf.:-) V""" 10 /Sr-r""-'7 oro" ~.l 1ft oJ r ....{-1-coN J"''"), . [urc..foSia/VJi vk t.UI l\ ..519~ CL,J~w /J!Pt kel Reviewer/Inspector Name : Reviewer/Inspector Signature: Page3 ofJ Phone : 9/P -5~.?-:IJ tSI Date: /£)-)''')' -/{)t? 11412015 ,1111111111111111- 0peration Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: 0 Follow·up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: 11·rt{ij ( ll Arrival Timed !{'eo P I Departure Time: 1/! 1' jY I County: fl}-~ Farm Name: ~ hi'\v\¥ ~b Oe fo...r'""'l S Owner Email: I Owner Name: .J--0 \, Y\ ·}Z (-{o ~~ Phone: Mailing Address: Physical Address: Facility Contact: _.Jo..C~"=c;:.:."'.....:tl-...:...; ,~5 _____:8~. _cw--____;(A.)_tc_._f(_ Title: Phone: Onsite Representative: l( Integrator: Certified Operator: Certification Number: 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~ Discharge originated at: 0 Structure 0 Application Field 0 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) 0 Yes 0No 2. Is there evidence of a past discharge from any part ofthc operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Pa~:e 1 of 3 DYes [JNo 0 Yes LfNo DNA ONE EfNA ONE ~A ONE ~A ONE DNA ONE DNA ONE 214/2015 Continued ~~ty Number: @ d -l b b jnate of Inspection: tft /'11 &u( n 1 Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~NA ONE D Yes D No B"N""A 0 NE Structure 5 Structure 6 DYes ~ DNA ONE 0 Yes [LJ1fo DNA 0 NE If any of ques.tions 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? 11 . Is there evidence of incorrect land application? If yes, check the appropriate bo x below. 0 Yes !Z(No D NA 0 NE 0 Yes C2{No DNA D NE DYes ~o DNA ONE DYes IL(No DNA 0 NE DYes ~o DNA ONE 0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area 12. Crop Type(s): (t{; Jtd- 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of prop er ly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check the appropriate box. 0WUP Dchecklists 0Desihrn D Maps D Lease Agreements 21 . Does record keeping need improvement? If yes , check the appropriate box below. DYes DYes DYes DYes DYes DYes DYes DOther: DYes ~ DNA ONE ~ DNA ONE 0"No DNA ONE ~0 DNA ONE [31fu DNA ONE ~ DNA ONE ~0 DNA ONE [31fo DNA 0 NE 0 Waste Application D Weekly Freeboard D Waste Analysi s 0 Soil Analysi s 0 Waste Transfers 0 Weather Code 0 Rainfall DStocking D Crop Yield 0120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? D Yes [d"No D NA D NE 23. If se lected, did the facility fa il to inst a ll and maintain rainbreakers on irri gation equipment'! D Yes ~ D NA 0 N E Page 2 of3 Z/412015 Continued !Facility Number: rq( -l7 t:, {; I Date of Inspection: /fa I'Yey I 7 I " 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box:(es) below. DYes [a1'fo D Yes [2l"'No DNA ONE 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 offrrst survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a ref,rional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. D Application Field D Lagoon/Storage Pond 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? 0 Yes ~0 DNA ONE DYes ~0 DNA ONE DYes [9"N'o DNA ONE DYes ~ DNA ONE DYes 6 DNA ONE DYes ~ DNA ONE DYes ~DNA ONE DYes ~DNA ONE DYes ~DNA ONE ~o?mtents (refer to-question#): Explain anyYE~answers and/or any additional recommendations or,.lloy,otber comm~ntS:; : ~-'' .- ufe-draWings offacllity to better explain situatio~s (tis~ additional pages as necessary). ,. ' .:, ;, ··. ' ' --:·> :~ ' ' ' w~~~ c~c b.~ · ( 0..-"\ -'t-1'2. --{(v Reviewer/Inspector Name: Reviewer/Insp ector Si gnature : Page3of3 ~ ~~~~~~~~~~~~~====~ Type of Visit: Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: ." ~ne 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: 1/t'±-J .t I Farm Name: Arrival Time: I zr 'v 0 ; Departure Time:l I .' 26 I County: z~tr-Region: fl?J Owner Email: Owner Name: Phone: ~. . . : .\"·. ;• Mailing Addres,s: · _____ ,_:--:-:--------------------------------------r Physical Address: •• ·"ill._ ... -. . j J,,. Facility Contact: .. ~}~~. O~site. Representati~e.: ._·....,D ... &'""~::::;..:;..;;;=:::;....-------------- '(/ :~ce~fled Oper~t~r: .:.:;..·~ ·__,· ..:;./--&.'t2"''ri..___._r;"'-_7....._··+z__,g,__"""""---'cA~&~c__,-z::::::::.L..fWP...=::;..~L:.-=----- ~-;' :j .' • , _"; ' . .~ '' : .-• _;: ,• • -I t ·:;. Ba~k,iup'9P.erator: :....;:'-: ..• _:"";--:-·,--:-.'------------------~?. ;·~~cation of F~rm/"·~!j<·~ I:;~~. ~·:: ·.·1 . :_;:> : . -~- ~~~-~~; !.· ... ,. . . . , . -~ .. , ~ .i. ~~: ... · ._ .... _-: { !, ., ~: ,i. I ., "". !. (" ·, \. Latitude: .. · . . ! ~-• f ~~·· Discharges and Stream lmoacts (:",'. ·Lis any discharge observed from any part of the operation? ·-:,·'., . I·, , . f;') ·:' . ~· . t\= Discharge originated at: D Structure 0 Application Field a. Was the conveyance man-made? D Other: b. Did the discharge reach waters of the State? (If yes, notifY DWR) c. What is the estimated volume that reached waters of the State (gallons)? Phone: Integrator: Certification Number:. /t?Oif?i j Certification Number: Longitude: DYes ~No DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No DNA ONE 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page 1 of3 DYes DYes [EJ No DNA ONE ~0 DNA ONE 2/412015 Continued ~ • •••• J-. '. • I Facility Number: p---/,( k v( I nate oflnspection: /( E.col+- Waste Collection & Treatment ~ 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure3 Structure 4 Identifier: y;[_ /-rJc.u..,r Spillway?: Designed Freeboard (in): If t_q. Observed Freeboard (in): 'f:r-d-Z 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 ~o DNA ONE 0 Yes D No 0 NA D NE Structure 5 Structure 6 DYes 1ZJ.-No DNA ONE DYes !ZtNo 0 NA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR 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 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? ,8-Yes D No 0 NA 0 NE 0 Yes [B.No DNA 0 NE 00--Yes 0 No 0 NA 0 NE DYes ~o DNA ONE 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes 12J-No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area l2.CropType(s): br~ /f,Jocr?r--r;/ 13. Soil Type(s): .~ 1/r fL r 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lac k of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. OwuP 0 Checkli sts 0 Design D Maps 0 Lease Agreements 21. Does record keeping need improvement? lfyes, check the appropriate box below. 0 Yes f2l.No DNA ONE DYes [8_No DNA ONE DYes [RJ No DNA ONE DYes i)a_No DNA ONE DYes £2lNo DNA ONE DYes ~0 DNA ONE 0 Yes Sl'Jo DNA ONE Oother: DYes tzf--No DNA ONE 0 Waste Application D Weekl y Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code 0 Rainfall D Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 23. If s elected, did the facility fail to install and maintain rainbreakers on irrigation equipment? Page 2 of3 0 Yes gl-No DNA D NE 0 Yes 12}--No 0 NA 0 NE 21411015 Continued • I Facility Number: 42': -?; l ~t I Date of Inspection: //-3-Qlo(t,; I 24. Did the facility fail to calibrate waste application equipment as required by the permit? ' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. D Yes (21-No D NA D NE DYes ~o DNA ONE 0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriall: box bduw. 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: Page3 of3 0 Yes f9.-No 0Yes ~o DYes &:l No DYes 0-No DYes ~No 0 Yes 3-No 0 Yes gNo 0 Yes ®No DYes ~o DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE Phone: 91v-303-0 [57 Date: //-3-..;:vI~ 21411015 ·-·~-~~~-!!!!!~~~ 0 Technical Assistance Reason for Visit: 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: l/1-rc/;rArrivaiTime:l;/;'D~ I DepartureTime:l 1/: ]t) I County: ... {76'-L-Region: ~0 G-d "'Y'L ~:? 7?.. t>c~ J &~1?-1....6 Owner Email: Farm Name: Owner Name: L. Phone: Mailing Address: Physical Address: -------------------+--.-------------------------'G:.......:;.._f":_-c-_.,.._r~/lf.<..:......:.-'-tJp~~<--~------Title: _. ..... d.L..:....o.......::.J'----=~0-=:..r'P--=-t:'-c.;:_ __ , __ Facility Contact: Onsite Representative: __ 7..,£_~---=:.....=:::...._ _____________ _ Certified Operator: __ L_o_r_-c;:;;.....;/_1._a.. __ --=.Z~~=-~--=:.....:~-P~7:....' ____ _ Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Application Field a. Was the conveyance man-made? 0 Other: b. Did the discharge reach waters of the State? (If yes, notify DWR) c. What is the estimated volume that reached waters of the State (gallons)? Phone: Integrator: -------------- Certification Number: /oo 15'/tf Certification Number: Longitude: DYes ~0 DNA ONE DYes DNo DNA ONE DYes 0No DNA ONE d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes DNo 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 i5!No DNA ONE [il_No DNA ONE l/4/1014 Continued loate oflnspection: 11:17-tr I I Facility Number: Waste CoUection & Treatment ._;\ 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure4 Identifier: Il.P p~ , Spillway?: Designed Freeboard (in): ir {t Observed Freeboard (in): ;l-( ~(:, 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 (l}No DNA 0 NE DYes 0No DNA ONE StructureS Structure 6 DYes SNo DNA ONE D Yes I)J-No D NA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~o DNA ONE DYes ~No DNA ONE DYes ~o DNA ONE 0 Yes [28.-No 0 NA 0 NE II. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. D Yes [L}No DNA 0 NE 0 Excessive Ponding D 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): ~/'m{,~ ~~-r::r / 13. Soil Type(s): .,zfu/?;ttXf/-r::: ]) 14. Do the receiving crops differ from those designated in the CA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reguired Records & Documents DYes ~0 DNA DYes 0-No DNA 0Yes ~No DNA DYes ~No DNA DYes 12JNo DNA ONE ONE ONE ONE ONE 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 0 Yes ~ No 0 NA 0 NE 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check D Yes 1:8--No 0 NA 0 NE the appropriate box. OwuP Dchccktists 0Design 0Maps 0 Lease Agreements Oother: _________ _ 21. Does record keeping need improvement? Ifyes, check the appropriate box below. 0 Yes [B..No 0 NA 0 NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~No 0 NA 0 NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? Page2 of3 DYes ~No DNA ONE 214/2014 Continued •I Facility Number: p;J--(;e:, '( lnate oflnspection: J fl--J.;L-/£ I .... ~-24. Did the facility fail to calibrate waste application equipment as required by the permit? D Yes [2J" No DNA ONE DNA ONE I 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes ~No the appropriate bo~(es) below. 0 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 G!J:No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes j5No DNA ONE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes and report mortality rates that were higher than normal? (ig,No DNA ONE 29. 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. 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 li?J.No DNA ONE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes 64No DNA ONE 0 Application Field D Lagoon/Storage Pond 0 Other: ----------------------- 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? 7-?-ot.S Reviewer/Inspector Name: Reviewer/Inspector Signature: Page3 of3 DYes ~No DNA ONE DYes DNA ONE DYes DNA ONE Phone: q//)--:(~Y-3::?-00 Date: ;'/-/,:Z -~1~ 214/2014 ompliance Inspection Operation Review 0 Structure Evaluation Reason for Visit: e'Routine 0 Complaint 0 Follow-u 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit : Arrival Time: I lf/)41 Departure Time:l71 IQ I County: cS.1}'1( Farm Name :_---.G"'-!.,r_;_r...,.:s:,..._.f'<....:..:."...:!!!a=)--fi.:....4t_~---';....._----Owner Email: Owner Name: Hvter, G rl~s Phone: Mailing Address: Physical Address: -~.;;.........5"_0-...J{?"""'· ~f"'"....;.\~~u~I1J..:;;a.--nP~-;;;:~~";S-ht----------------- n /J --(Mie (tl Facility Contact: 'fW!i (;~ ~c.-Title:----------Phone: \( t{ Oosite 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 D Application Field 0 Other: a. Was the conveyance man-made? b . Did the discharge reach waters of the State? (If yes, notify DWR) c . What is the estimated volume that reached waters of the State (gallons)? Integrator: -------------- Certification Number: 1:::__("--'J.~'-{=----- Certification Number: Longitude: DYes ~DNA ONE DYes 0No cr'A ONE DYes 0No @NA ONE d . Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No Q'NA ONE 2. Is there ev idence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Pagel of3 DYes DYes gNo DNA ONE [!(No DNA ONE 114/2014 Continued IFicility Number: I nate oflnspection: / 7{Jet--I i". Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes~ DNA ONE DYes 0No ~ ONE Structure 5 Structure6 DYes ~o DNA ONE DYes ~o DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? 11. Is there evidence of incorrect land application? lfyes, check the appropriate box below. DYes ~o DYes ~o DYes ~o DNA ONE DNA ONE DNA ONE DYes ~o DNA ONE DYes~ DNA ONE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. Oop Typqs) -C;f ee 0$ 13. Soil Type(s): Aw v•tff ~ 14. Do the receiving crops dirrer om those designated in theCA WMP? I 5. Does the receiving crop and/or land application site need improveme nt? 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 fa il to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readil y available? If yes, check the appropriate box. Owup O c hecklists 0Design 0 Maps 0 Lease Agreements DYes DYes DYes [g1fo ~0 B"No DYes ~o 0 Yes B'No DYes ~0 DYes (3""N"o 00ther: DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 21. Does record keeping need improvement? Ifyes, check the appropriate box below. 0 NA 0 NE DYes ~0 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers 0 Weather Code 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute In spections D Monthly and 1" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and m aintain a rain gauge? DYes ~o 0 NA 0 NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes QrNo 0 NA D NE Page2of3 21412014 Continued IFaemty Number: az -''L 1 ~ate of Inspection: /7 E;)~l.-( I i4. Did the facility fail to calibrate waste application equipment as required by the permi t? 25 . Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box( es) below. ~es 0 No DNA ONE [9'fes 0 No D NA 0 NE 0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels 0 Non-compliant s ludge 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 ~0 DNA 27 . Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes ~ DNA Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes B1'fo DNA and report mortality rates that were higher than normal? 29. At the time of the ins pection did the facility pose an odor or air quality concern? D Yes ~ DNA If yes, contact a regional Air Quality representati ve immediately. 30. Did the facility fail to notifY the Regional Office of emergency situations as required by the DYes (B"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. DYes ~ DNA D Application Field 0 Lagoon/Storage Pond 0 Other: --------------------- 32. Were any additional problems noted which cause non-compliance of the permit or CA WMP? DYes ~0 DNA 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~0 DNA 34. Does the facility require a follow-up visit by the same agency? DYes ~0 DNA Comments (refer to question #): Exphiilrany';YES,answers and/or any additional recoiii'*~nd.ations .or any otb'et~,comme -· "--,._ ': '.":_;·~;:~··.~,~.: •, ,'_{~'!l''~·~~-t=.! ... , '• •' •:T'J;:.""lt~.•:t....':~ Use drawings of facility to better explaiti situatiQ_~'f(lise additional pa es as necessacy):J~~t:\:. · •. ':.~:~.:;0;~,~ N.,ec£ &c (,~.~., o~ ~..-:( l~-i~-l3 {\k~ (;{~e ~4 · f ~~ ? {d--(b-1] M top'u} ~~\\ P~ -flLD~R Sv.A-e. 1 t 5 _'II d-J-5 c,~~(\_ ~~ ~~11.\1~ NL--z...s5 o\ ONE ONE ONE ONE ONE ONE ONE ONE ONE Revi ewer/Inspector Name: ..::~Z\..L·-'-, .... \ .... \~D....q..,rJ-'-~c~::-==t-----------------­ Reviewer/Inspector Signature : --~.li::0:.4o~""Wt-_O:: _ _,~~x:;;¥---------------­ Page3of3 Phon e: 433-333 Date : /J ~c~l q 11411014 Operation Review Structure Evaluation Reason for Visit: ~Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other Date of Visit: lloh I J 13 FannName :~(;~r~~~~--~~~--~WL~~~ Owner Name: Mailing Address: . r' ~ t-:' Physical Address: (050 lO!VllfJ ~ ra I .SOc 7 Time: U 1; SS:Nf I County: Sotnym Owner Email: Phone: Facility Contact: "illlm.f r Ro €.StJJ Title: ---------Phone: Region: fRo Onsite Representative: "Jot(lfJ Rl>ekl) Integrator: .....:...M.:..-~B:;.._ _________ _ Certified Operator: \1t'chCI£( lJfrdf/\ 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: IE' 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)? Certification Number: ~=%~._f _____ _ Certification Number: Longitude: ~CIJ 8J Yes S)No DNA ONE ~Yes 0No DNA ONE DYes l:i"No DNA ONE d . Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE 2. Js 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 8No DNA ONE 18'-No DNA ONE 2/412011 Continued 'I Facility Number: $ d, I Date of Inspection: I 0 I (I , n 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 Identifier: Spillway?: Designed Freeboard (in): I '1 Observed Freeboard (in): ~ l{f5Q Structure 2 4 I Structure 3 Structure4 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 StructureS Structure 6 DYes ~No DNA ONE DYes ~No DNA ONE If any of questions 4..{) were answered yes, and the situation poses an immediate public health or environmental tbreat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the 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? j8 Yes 0 No D NA 0 NE DYes ~No DNA ONE 0 Yes ~No DNA 0 NE 0 Yes ~No D NA 0 NE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN> 10% or lO lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12.cropType(s): U,,ial 8,-rnuda -Hay;.SrroUgcorb (JmtetJ 13. Soil Type(s): ~ 111/fe.. B 14. Do the receiving crops~er 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? 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 the CA WMP readily available? If yes, check the appropriate box. OwuP 0Checklists 0 Design 0 Maps 0 Lease Agreements DYes QYes DYes DYes DYes DYes DYes Oother: ~No 1)1 No ~No I8J No (Sa No ~No 6'fNo DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No DNA 0 NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Weather Code 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? D Yes ~ No D NA 0 NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes 0 No [2f'NA 0 NE Page 2 of3 21411011 Continued lFacility Number: I Date of Inspection: JlJ Itt lf 1 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. ~No DNA ONE SNo DNA ONE ~ailure to complete annual sludge survey 0Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal?- 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i .e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Application Field D Lagoon/Storage Pond IE Other: NhtsfD!-fleldf 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? DYes 5SJ No DYes DNo DYes ~No DYes l)d No DYes 15jtNo ~Yes 0No DYes JKI No DYes ~-No DYes ~.No DNA ONE ~NA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 1. Small dlsdtttje at CO!Mr of f!9h()1e. ~ n~/O~Yir ltyto'l. Thf.r har bee, YV()r~fl th {¥-ftJJ'tMf h.-t-~at-i-oo svccecsf'<-f}. Pre4fe d !J ar,..J tJd-s ,i/e IJf fo.;,/lfh 6, <1-~ l-ea lc. . Ple.1,e. t~~ue-~~JJ.~bJ lJn lott~r J~1_olr] to-eoc;llfale rNJw0J J, ~. Plt~e ~~'- Or Sft!J 8 ro.JJ i}) ~~"' k behv-Pe~ ~u1e OtvL f 0 hfB-1 yoo, , Rert of J djofh rArl 1-of ltyoa-. have 8fX't'L81'1lJf covtr l~) 0/IJ. thtrrao~ CtriH;arle df-cotJ{f'!Je ftrmlt q. chedti(J'b ]eft d u'~1 ~-f~t"ho". SfttJ.! retarl.l ~Pi'J 8 t»J._ shbffJ (l}c[q{ a.r rosW. 'Nth -k-()14~ 1-I..) .. ,J\·trifen_, IJof-y-e+i.rzcfr [nD\-tlJ.....li, PAt{), . PleaJe_get-ca/ihral,~a-, ~Wtt-e e.J at-yeor (new ~eetJ, . No &/,~e. s wo/ wo.s dOJe ,',.. ~ 01;). , f1to1e do 01-e ~ Ol 013 • ~ 011 sw •e; s h1l>'f'tl pltnfy af-Hfvl'cL wah)Je.t-Vo/v,e_ ~oh~. 0, serveJ _ai a_ ntftite of-dl'flciP~CJ fiT ~t. fegJ( er,L 'ftlilve 1o 'ta~ ~ s lA'v-ey, \:_uon-~l}-bv-Ooo.r; P.l~~'0 wh~ 1't~''s"h't.«f. .. 1 • ...,_,, 5 } lii\--H~IfnutNJ ~vam..tv. sfhoi>O-;' f+ffl't}tl,iR: byn..,/ )I~~J,. ~ ~v Rev ie wer/Inspector Name : Rev ie wer/Ins pec tor Signa ture: Page3 of3 Phone : CfllHJ3-33DO /llf6i:e) Date:({-} I~ ~0 13 214110IJ . ~acility No. 'S()-{r;~'f Farm Name _.!G~t:....t.:)~~es::::.....:..PJ"""'-~--Date )O \1 I\ \3 Permit COC ___ OIC_ po~ NPDES {Rain breaker PLAT Annual Cert Daily Pipe ) FB Drops l10 "P ) ·()I(_ I ..... , I. m-n ... lOb.:riL lagoon Name, S for spillway . 1 2 3 Desicm Freeboard /last Recorded (in} [JqJ 41 ll'f/.34 Observed freeboard Sludge Survey Date bh'\/lJ SludQe Depth (ft} ,t:f\ LJ LiQuid Trt. Zone (ft) -s-.. ~ /083 Ratio Sludge to Treatment Volume if> 0.45 Date out of compliance/ POA? Calibration Date 1J-tP11 2 3 4 Ring Size (in} l.,:,r DesiQn Flow (gpm) ~ Actual Flow "'J.Qfi k Design Diam. (ft) w<;- Actual Diam. 'lfio Soil Test Date ~h /f3 Lff~1ll~ pH Fields ~I( Crop Yield Wettable Acres -- WUP / Lime Needed _()___ SJ:""" a.~ Lime Applied _12___ Cu-I ~ Zn-1 ~ f-1{-'tb-11~ Needs S (S-1<25) Jn;/iiu ~ Weekly Freeboard 7 1 in Inspections ......- Needs P --rr--~ 120 min Insp. __ _ Weather Codes Waste Date IJ.lltl.ID.. 'l.!fo If-,. lt.lll/t3 !Ub.?ln 'll:nlt.l -60 Day i> + 60 Day N(lb/1 000 Gal) .lo'tl-11 It 'tit* II .. ;)"( 1;~3 .~(/I "1'1 [;);;, L 1 pH ) / 17,~ ,/ A. / ··.&.J. .111. Pull/Field Soil Crop Acres PAN \ Al,.le (_ Q t\1,.-$6-~l" lA J!r' jq) d. I' 13. .1 ' J t..~ y G.3 L I .. Venfy PHONE NUMBERS and affiliations ~~5~1 Date last WUP FRO 1-· II -&7 FRO or Farm Records ' Date last WUP at farm Lagoon # i qi{'(Jq() 'App. Hardware Top Di ke 50.0 Stop Pump 4 fo . 0 Start Pump 48, ·~ Ia-\ 1 Conversion-Cu-I 3000= 1081b/ac; Zn-1 3000= 2131b/ac 4 .. 5 Window 5 6 - ·. 6 7 Transfer Sheets RAIN GAUGE 7 8 • Dead box or incinerator __ _ Mortality Records · Check lists Storm Water Max Rate Max Amt IH4r-&r:~ t'J, c_., I ,r{) F/ U ~ l6 .. P ~ t53XIs.J ~o.o 4 '3t"3 4~.'} IJ'\V> Vo '\!/ '1;f:JOJ:t. -//0)013 I Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: 0 Routine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: IJ las-J 1~ I Arrivai.Time:l<{i: SOA-fil . "\ Farm Name:~(a.JJ-r.~-:.1 I)'I...L..:..::;-e=:J....:R~tkJd!:::llaol~._-....1..t-"O.~'IIl~( ------- Departure Time:IJO ;aJAij County: Scmpo, Owner Email: Owner Name: H vrtb &1 'meJ Mailing Address: Physical Address: t?5D Gtf!Jffs }Qd. ) Falrrrq Facility Contact: 'JQmeJ · l<oe.ec6 Phone: Title: <0 kY n'ft= Phone: Region: F~O Onsite Representative: ---l.R...=....;;<})....L......lGJ~o~a.-"JmeLL.l!'+'f------------­ Certified Operator: M; chtlf l Ooalf/) Integrator: --LH4--....JB~::::... _________ _ Certification Number: .... a:;;;..~.::..=a...;:6_!,__ ____ _ Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts I. Is any discharge observed from any part of the operation? 0 Yes 'f):SI No 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? (If yes, notify DWQ) DYes DNo 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 DYes ~No DNA ONE ~No DNA ONE 214/2011 Continued JFacility Number: $ ~ I Date of Inspection: 7/~ y f ().. 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: Botkhl '¥ Spillway?: Designed Freeboard (in): l:l l'l Observed Freeboard (in): 40 ;;x( 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 r;i{No DYes 0No DNA ONE DNA ONE Structure 5 Structure 6 0 Yes ~No DNA ONE DYes g-No DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Docs 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? 'BJ Yes 0 No 0 NA 0 NE 0 Yes [8"No 0 NA D NE DYes ~No DNA ONE 0 Yes jRNo 0 NA 0 NE II. Is the re evidence of incorrect land application? lfyes, check the appropriate box below. 0 Yes ~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 Man ure/Sludge into Bare Soil 0 Outside of Accepta ble Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area 12. Cro p Type(s): Cmr/o) r?f'lmwiOx Ha,; SmoJ/ Grarb Ovfcreed.___ 13. Sod Type(s)o Azt2vllle_ \ ~ 14. Do the receiving crops d. er 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 ope rate per the irrigation desi~:,'ll or wettable acres determination ? Page 2 of3 DYes DYes 0 Yes DYes DYes ~No DNA ONE ~No DNA ONE g}'No DNA ONE j2No DNA ONE (g-No DNA ONE DNA ONE DNA ONE 21412011 Continued 4 .... (Facility. Number: q;o-. -h&Cf_ !Date of lns~ection: 1l.r'l· f ().... 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes ~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? DYes ~No DNA ONE 27. Did the tacility fail to secure a phosphorus loss assessments (PLAT) certification? DYes DNo I)?NA ONE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes ~No DNA ONE and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notifY the Regional Office of emergency situations as required by the DYes f&f No DNA ONE permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? Ifyes, check the appropriate box below. DYes ~No DNA ONE 0 Application Field D Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 0 Yes l&f"No DNA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 0 Yes 5aNo DNA ONE 34. Does the facility require a follow-up visit by the same agency? 0 Yes j8"No DNA ONE Reviewer/Inspector Name: Reviewer/Inspector Signature: Page3 of3 < ~ l ·· J')/] Facility No. ~6~-~~'1 Farm Name {; f ~J f<IY...._ I Date _____ _ Permit ., COC OIC\.._......-"' NPDES (Rainbreaker PLAT Annual Cert Daily Pipe) J FBD roos ~II . J -: FTTTI Lagoon Name, S for spillway DesiQn .Freeboard I Last Recorded (in) Observed freeboard SludQe Survev Date SludQe Depth (ft) Liquid Trt. Zone (ft Ratio Sludge to Treatment Volume if> 0.45 Date out of compliance/ POA? Calibration Date tl!r>lll 2 RinQ Size (in) kiT' Design Flow (qpm) "l£h Actual Flow l*q DesiQn Diam. (ft) :\4~ Actual Diam. '3Wo ~ 1 /Q 1~~-. ·Q ~8' j;) Q-lh1. 15,5() l~ 3 -.n~v So•l Test Date Y Ifni G... Y ()q It! Crop Y1eld 2 3q 3 I }':;l()l.. ~ JO/i> {~ 4 pH Fields Wettable Acres __ _ Lime Needed 0 WUP ......__-- Lime Applied Weekly Freeboard __ Cu-I J Zn-1 \../ c..kl 1 in Inspections Needs S (S-1<25) ~ -t• 11 Uof) 120 min Insp. _-_-_-=_-=_ Needs P 0 . Weather Codes Waste Date 1\.lL:nlr:\.. 1/:ltw/ J 1-,/JliJJ -60 Day + 60 Dav N (lb/1 000 Gal) pH Pull/Field Soil Crop Acres PAN i .J\.JB C"t;~· \,q ~ I "3 ... 3 ) ( . .) 4 \I-1!?3 All YroiiG,~-~ 'H) 4 5 Window , v \j Verify PHONE NUMBER.S and affiliations l)oxrSJ Date last WUP FRO \I Ill 0') FRO or Farm. Records lor:;> I Date last'WUP at farm Lagoon# ftl~: IQUltl'«> App. Hardware Top Dike .so l~/~ Stop Pump 4 ~ Start Pump 'J!d__ ) ~ "JJ . 1.10 {, 7 Convers1on-Cu-I 3000= 108 lb/ac; Zn -1 3000= 2 13 lb/ac 5 6 6 7 Transfer Sheets RAIN GAUGE 7 8 Dead box or incinerator __ _ Mortality Records Check Lists Storm Water Max Rate MaxAmt o.rn I f) J"-!f s £~Jd1 u( l..f*r ,_-;n-0'1 CIA?) 1'AOI3CifiOt-'XJ.(JiY>t'o L,~,-~ ltrMCflitl~ 0-11-( {) }Joy hceftr fKVI1 N&-i e Kth1-lJ1.,(] crl b ll\v'rS 11/111 Q / JP~ I~ Q_ T veJ r: !ry ) Tth'J 10 I q lrd ~ ed }1+-0iw(dft.!e k'm /)o...,j C(/q:Jf-/) d(J 'i I d IJ d!rn 'fVfl a\} co/fa-q,4M Pt'''n Co US -!{fl'(AVvil(::_ -a '5' Yig-cJ a fttrro:!.' ~(p-~ CQrl_ecL ~l'< ad ~~ 4 hrJ-c r I rr IJJ.. I p 11 vvvv/" Htf~J~.e q to-or76-d 11./J ~ f:x}r ~1M shtr'--3-lf-IO IA0\)00'-lO ( cJIJJ 1---?P-o? _!;(frJf fJ:J ohoe_ Operation Review 0 Structure Evaluation Reason for Visit: 0 Follow-up 0 R eferral 0 Emergency 0 Other 0 Denied Access Date of Visit: l!flri.11Jt I Arrival Timed~; SOAtj-I Departure Time: I I I'·~AI1 Farm Name: fQr tmf! RooL ftWJ ( Owner Email: OwnerName: -~~~r~~--C>~tu~~tZL--------------------Phone: Mailing Address: Physical Address: fotO ht~f { lrJ @iJo, AJC -/ Facility Contact: -LJRo.Jojlht+--G.=-f!u..Mu.;f:~ooL...£ ________ Title: 0t-'D-(f" J County: ~J?s{h , Phone: Region: FRo Onsite R epresentative: _\.....,.tKt.......,G._.?u.fwlb!""fJ""--------------- Certified Operator: H ichoe/ 0 OrtJeq Integrator: ..... H...l....-......:..BL---------- Back-up Operator: Loca tion of Farm: Latitude: Di sc harges and Stream Impacts I . Is any discharge observed from a ny part of the operation? Discharge originated at: 0 Structure 0 Application Field a. Was the conveyance man-made ? 0 Other: b. Did th e discharge reac h wa ter s of the State? (If yes, notify DWQ) c. What is the estimated vo lume that reached waters of the State (ga ll ons)? Certification Number: Certification Number: -~__;_~......;::;~;..../'------- Longitude: 0 Yes 18 No DNA ONE D Yes 0 No DNA ONE Q Yes 0 No DNA ONE d. Does the d ischarge bypass the waste management system? (If yes, notify DWQ) DYes 0 No D NA ONE 2. Is there evidence of a past discharge from any part of th e operat ion? 3. Were there any observable adverse impact s or potentia l adverse impacts to the waters of the State other than from a di sc harge? Page I ofJ 0 Yes D Yes ~No DNA ONE ~No DNA ONE 21411011 Continued 'lhcilit)' Number: ~a -fahY !Date of Inspection: 'lla3lll 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: Ba&,. TOI Spillway?: Designed Freeboard (in): l9 17 Observed Freeboard (in): 3~ ~:!. 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? 0 Yes ~No 0 NA 0 NE 0 Yes .Ja 0 NA 0 NE Structure 5 Structure 6 0 Yes 181 No 0 NA 0 NE DYes fiS}No DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement ? ~ Yes 0 No D NA 0 NE D Yes fiJ No 0 NA D NE D Yes ~No DNA 0 NE D Yes ~ No D NA D NE 11. Is there e videnc e of incorrect la nd applicat ion ? If ye s, che ck the appropriate bo x below. D Yes rn No DNA D NE 0 Ex ces sive Ponding D Hydraul ic Overl oad 0 Fro zen Ground D Heav y Metal s (Cu, Zn , etc .) D PAN D PAN > 10% or 10 lb s. D Tota l Phosphorus 0 Fa ilure to In corporate Manure/Sludge into Bare Soil D Outs id e of Acceptable Crop Window D Ev iden ce of Wind Dri ft D Appli cation Outside of Approved Area t2.cropTyp e(s): Coaml ~rmn:/11 Hav·.S~na/fara,b OverJI¥jj t/ 13. Soil Type(s): futrvvfUe. Is AvO 14. Do the rec eiv in g crops ~itfer from th ose de s ignated in theCA WM P? 15. Does th e rece iving crop and/or land applicati on s it e need improveme nt? 16. Did the fac ility fail to secure and /o r op erate pe r the irrigation design or wettable acre s dete rminati on? Page 2 of 3 DYes !2l'No DNA ONE DYes !BiNo DNA ONE 0 Yes ~No DNA ONE DYes ~N o DNA ONE DYes 183No DNA ONE 0 Yes ~No DNA ONE ~Y es 0No DNA ONE 0 0 th er: ~Y e s 0No 21412011 Continued ~,Facility Number: <{ ~ I Date of Inspection: q Ia 3/ l 1 I 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. 0 Yes ~No D N A ONE 0 Yes ~No DNA 0 NE D Failure to complete annual sludge survey 0Failure 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? lfycs, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. D Application Field D Lagoon/Storage Pond ~ Other: Mn spra.; f; eiJJ 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? DYes fig No DNA D NE DYes 0No 15dNA ONE D Yes ~ No D NA 0 NE 0 Yes (E No D NA D NE 0 Yes [8No DNA D NE ~Yes 0No DNA ONE D Yes ~ No D NA 0 NE D Yes ~ No D NA 0 NE DYes ~No DNA ONE I. \\1~:\-\\ lh cttn. netv ~ jh 0-l.ie. d. -\-o be.. rvor kerl. o, In n -€«" fvtVte, -n,· f i J ~"' the. .stht e ar fa.. a .rP€ Cracl{ """"dt'r"'or-flvg.rl laJ"t yeot DAd probrJk,~ Is~ vl\d-Q-.jrOv,.lproblen. l I GotJ_ j 0 b Df-mo"'fhq I ~001 Ovbld~ btnk I Please. chof. rvoat; rv-eeds a, rllr{d"P cf \aJlXh I I wn I()~ ~k c« ( ()( fl'f/' ()"f-( ~ Otn I h lew d 0 wn ' n Hvrrfco, e lrene. Vo aeporih+ d..omay -fo dIke. b()l k at-+Ms +·rne . Pleose. p (c~ Uf tra th 0, i(\s:de lxJ.1tJ of. I ~9oen J. 0, 'The. worle Pta, ~0 .t rD>hl. bvt not 50ne uf-t1Je. bacl(Jr~ !Afctma-l,'or?)'Svch C/f €mfl'9enc1 clleclt llrl-J, Ttvp r,·jerJ ~ere. addftl._ lo:rt year l wi'+ h IYP..cs crof-shve}t~~l a cop1 o+he. ne..,_, J:rr~crh'cn J-e1~n ii nPPdfli. ~1. Pleare Vje COif~ w ba/{J!(e W,r Crtf,l~o ~OrA~~~~ &' pro.l eve/f'f-J .sho...td hn~ b~ ued HeeL -+P Cnusf-a l BermvdO-lr·.skod ~ rY.e. bvt-'rvovld not ha~ f!p_(fderJ... ~A-ftlth ~ftiYl'flo.-. PleaJl~. roJt [rOf\}l'fttL ( no..) c~i) f-a J0/1, I ~lean: WOrlc Uf ~(I) I 0 .s l vdJe.S~~ f.eadinjJ, Slvri_Je Je~IJ or-e not-1)._ rro blf-"1 llf-bnj OU1i. Reviewer/Ins pector Name: Reviewer/Inspector Signature: Page3 of3 Phone: ~IQ-113J-3JoO.{offi'f J I Date: Sep-rt~ ao II 21412011 Checicr <h-ie ~for Ot A L .~ C-WJ) -IXJ lld-* ~-3~0 Farm Name ....;:Cot::..:......:.-.iJn:...L..-e=-..r.j_JZ'---=-"tL _____ Date q ld} / f I • Facility No. <6d-{lbt( Permit ;......./ COG ._/ OIC_ NPDES (Rain breaker PLAT Annual Cert) Pop. Design Current Type Lagoon Spillway Design freeboard Observed freeboard (in) Sludge Survey Date Sludge Depth(ft) Liquid Trt. Zone (ft) Ratio Sludge to Treatment Volume Calibration Date 1alrs-IJ1 Design Flow .~() Actual Flow ~qt? Design Width :Jqf:_ Actual Width jhf) ,, Soil Test Date q ~q}u ctr' pH Fields b~ Lime Needed _,0""--- Lime Applied Cu-I ____!L Zn-1 C7 Needs P tJo Cro Yield -, #I FB Drops 1~111 I(() ,, <CU. I' "'1 I 1 2 ~I ~~~Ito fd.li)S/Jf) ~~~~~- '?xi l.-S l,<;f If};)? 2 3 4 5 Pull/Field Soil Crop Acres PAN l ocl ' 1~1 ~q(C-. P(CI-} ~ ~ 1 . Q, " "'1P '\..-10;}0161,) -01(/~1 mverify PHONE NUMBERS and affiliations Date last WUP FRO Da'e lar WUP at farm FRO or Farm Records HI~/Op f J ) b) Lagoon# · Top Dike 50 50 Stop Pump 4 ~ ~ Start Pump ~ d ~ Conversion-Cu~~O 0= 108 lbfac ; Zn-1 3000= 213 lbfac \qQ.( ~\~r>d.; 11~~ G,~ ~ 5 6 7 ~ t!lr.SO ~;.~ 6 7 8 ~UGE eadbo or incinerator Mortality Records 'I l'fflt., Jr.~e_ Window Max Rate MaxAmt 0,(.. t.n App. Hardware Compliance Inspection Operation Review Structure Evaluation Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Denied Access Date of Visit : I q la.~d If I Arrival Time: I ot~so Farm Name: 6-J)nel 'RCVld F41hl ( > Owner Name: Hvrlh G, 1Prt' ( Mailing Address: Departure Time: I[' ~oo "'r Owner Email: Phone: . Physical Address: cRm Gt t"me, rM_ J Fa j 1 t!1 hie< Facility Contact: ]?OD Gt imfC I County: sa.,~.?l I Phone: Region: Onsite Representative: __,R~lh~,.--::..;G,"'c~...fN.:..:.i ..a:.·,.iof>c:.... ___________ _ Integrator: ,., vrfly Brol(h Certified Operator: H !thO£ I OOrd.f'() Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts I. Is any discharge obs erved from any part of the operation? Di scharge originated at: riSJ Structure 0 Application Field a . Was the conveyance man-made? 0 Other: b. Did the disc harge reach waters of the State'! (If yes, notify DWQ) c. What is the es timated volume that reached waters of the State (gallons)? Certification Number: _..c;rb=-==~'-'6~1------ Certification Number: Longitude: ~ II! Yes DNA ONE (8l Yes 0No DNA ONE DYes j8No DNA ONE d. Doe s the discharge bypass the waste management syst em? (If yes, notifY DWQ) DYes 0No DNA ~NE 2. Is there evidence of a past discharge from any part of the opera tion? 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 ~No DNA ONE 21412011 Continued •!Facility Number: $'0-I Date of Inspection: 'f b-3) IJ 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: 8oftm tor Spillway?: Designed Freeboard (in): lg ~~ Observed Freeboard (in): a a ~j 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No 0 NA 0 NE 0 Yes 0 No 0 NA 0 NE Structure 5 Structure 6 D Yes ~ No 0 NA D NE 0 Yes l2No 0 NA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? ~Yes 0 No 0 NA 0 NE DYes !Sa"No 0 NA 0 NE 0 Yes ~ No 0 NA 0 NE DYes ~No 0 NA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN 0 PAN> 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): Coorlal Berm vda.. thJjSmo ''JrQJb ove·seeJ. 13. Soi!Type(s): Avtryvi Ue.. \s AvB 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components ofthe CAWMP readily available? If yes, check the appropriate box. Owup ~Checklists 8Design [8-Maps D Lease Agreements DYes ~No DNA ONE DYes !}§No DNA ONE DYes !E'No DNA ONE QYes (;8J'No DNA ONE DYes ®No DNA ONE 0 Yes DJNo DNA ONE ~Yes QNo DNA ONE 00ther: 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 NA 0 NE ~Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code D Rainfall D Stocking~ Crop Yield D 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey ~Yes QNo 22. Did the facility fail to install and maintain a rain gauge? 0 Yes (Sd'No 0 NA 0 NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? Page2of3 D Yes 0 No ~ NA D NE 21412011 Continued !Date of Inspection: ql~311 1 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. DYes ~No DNA ONE 0 Yes {2fNo 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 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 si tuations as required by the permit? (i.e ., discharge , freeboard problems , o ve r-application) DYes ~No DNA ONE 0 Yes D No ~ NA D NE DYes ~No DNA ONE D Ye s (5t'No D NA 0 NE O Yes ~No 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. !StYes 0No DNA ONE ~ DNA lWNE 0 Applicat;on F;dd 0 Lagoon/Stmage Pond ~Other. filots~ =fi£1Jr 32. Were any additional problems noted which cause non-compliance of the perm~; CA WMP? ~0 Yes rg-No r)a No j8No DNA ONE DNA ONE DNA ONE 33. Did the Revi ewer/Inspector fail to discuss review/inspection with an on-site representati ve? u fJI"Yes 34. Does the facility re quire a follow-up visit by the same agency? Reviewer/Inspector Name: Reviewer/Inspector Signature : Page3 of3 0 Yes or any other · .. ·:: •... ·.,..,. :',. "."r'·· -.•. ·.;.~· . Phone: qlfJ-l/33-33/Joltfflc~ Dato ' s.rt<PdOII '/411 01 I Type of Visit ~Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit 0 Routine 0 Complaint ~Follow up 0 Referral 0 Emergency 0 Other D Denied Access Region: f@ rrival TimediJ', ~ At11 Departure Time: II~ l/0 'P 11 County: .9J1Hpsth Farm Name: 6r~et Roodg 'FamS Owner Email:------------- Owner Name: -~R.r.Oi.&.+--------~0f:::::.....:.r......!I'J?:....:.e.I'.=. _____ _ Phone: -\ Mailing Address: ----------------------------------------- Physical Address:----------------------------------------- Phone No=-----~---Facility Contact: ...~.t~)O:::L;IY!L..L.k:eJ:.~.--_ ____:.RJ>-=-:escb=~---Title: __,H...,.tn""----'-'aT-"~'l-"ft: _____ _ Onsite Representative: --=-~=_,Y\__.__...:::G::......r~r:::.M&.:.:g~---------Integrator: ........ H-4-----B~------------ Certified Operator: H \cha~) OaJ-PI) Operator Certification Number: -------- Back-up Operator: --------------------Back-up Certification Number: Location of Farm: · Latitude: D OD'D" Longitude: Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? rl§fYes 0 No DNA D NE Discharge originated at: ria Structure 0 Application Field 0 Other a. Was the conveyance man-made? b. Did the discharge reac h waters of the State? (If yes, notifY DWQ) c. What is the estimated volume that reached waters of th e State (gallons)? d. Does discharge bypass the waste management system? (If yes, noti fY DWQ) 2. Is there evidence of a past di scharge from any part of the operation? 3. Were there any adverse impa cts o r potenti a l adverse impacts to the Waters of the State oth er than from a di sc harge? Page I of 3 .RYes 0No DNA ONE gJYes 0No DNA ONE I fSl-Y es 0No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE 12128104 Continued . . I Facility Number:~~-h&Y I Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: ------- Spillway?: DYes ~No DNA ONE DYes 0No DNA ONE Structure 5 Structure6 Designed Freeboard (in): -~'J...:oq~---_....~\_9.~....... _____________________ ------ Observed Freeboard (in): __ Y.....:.....;-~;;;,__ ___ Lt_.:..,J.L' ---------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? DYes EitNo 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 ofthe structures need maintenance or improvement? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes 12fNo DNA ONE DYes ~o DNA ONE DYes ~No DNA ONE DYes 0No DNA j3'NE 11. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes D No DNA fi:l NE D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area 12. Crop type(s) ------------------------------------------------------------------------- 13. Soil type(s) 14. Do the receiving crops differ from those designated in theCA WMP? DYes 15. Does the receiving crop and/or land application site need improvement? DYes 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?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/Inspector Signature: Pagel of 3 DYes DYes ~No DNA ONE 0No DNA lS}'NE 0No DNA ~NE 0No DNA RNE DNo DNA ~NE _"'\ Continued rvC /f # I Facility Number: q) g,-~~~ Date oflnspection ~IID7llf l Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropirate box. 0 WUP 0 Checklists D Design 0 Maps 0 Other DYes DNo DNA ~NE D Yes D No 0 NA E;;l-NE 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes D No DNA ~ NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification 0 Rainfall 0 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? 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 represe ntative? 33. Does facility require a follow-up visit by same agency? Additio"n~Jl§6.#11Deots·•and/or ·orawings:·" Page 3 of 3 DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes 12128104 ~No DNA ONE 0No iSlNA ONE 0No DNA ~NE DNo DNA (SiNE ~No DNA ONE DNo ~A 'liNE ~0 DNA ONE ~0 DNA ONE i8No DNA ONE 18No DNA ONE ~No DNA ONE ~No DNA ONE ~~" ~ .. :"':' ;.>"'--"•-. -~·l """"""""'· ' -~,..., .··:---:..:;:!~~~' -....-,..:;-"" ~. J IVS PECTf OM 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ~Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access DateofVisit: l10hi)/(Q I ArrivalTimcdlf~(S'/41 I DepartureTime: lJ;jQ PHI County:---!~:.....:_-Region: FRO Farm Name: Gc Vnfr RcarL fOrttf Owner Email: ------------- Owner Name: -....;..R=O\.._._ _______ ...::&.~r/Jn:;.;...,.::f!.J=-------Phone: Mailing Address: -----------------------------------____ _ Physical Address:---------------------------------------- Facility Contact: J"OI?'lf.J Roesch Title: Hfh~ Co-~1\tJ: Phone No: 919 dd.}--1 q J..O Onsite Representative: .... )D........,I ... m£......., ... 1_..z.f0p""""......,S'c._·h"+----------Integrator: ......:..t-1..:..--':B=-------------- Certified Operator: ...:..M...~..~.~ootch""""'ae~f~---_ ___.D~O«J'""""-~£, .... a....._ ___ _ Operator Certification Number: ..... ~ ......... '-=~-'~~~---- Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? ffYes DNo DNA ONE Discharge originated at: ~Structure D Application Field D Other a. Was the conveyance man-made? b. Did the discharge reach waters ofthe State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Page 1 of 3 1)5. Yes 0No DNA ONE DYes fS{No DNA ONE ~Yes 0No DNA ONE ~Yes 0No DNA ONE DYes 'fia"No DNA ONE 11118104 Continued I Fac~ity Number:<6a.., -V;t,'j Date of Inspection hOh~hO l Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a .. If yes, is waste level into the structural freeboard? Structure l Structure 2 Structure 3 Structure 4 DYes &fNo DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 Identifier:-------------------------------------- Spillway?: DesignedFreeboard(in):---=\~qL-------.!...'q..J_ ___________________________ _ Observed Freeboard (in): .....~.o~~----_ _.).L..~J-------------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed ? DYes 18No DNA ONE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed DYes 0No 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 1 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? t8'1Yes 0No DNA ONE DYes 1,5a No DNA ONE 0 Yes ISI'"No 0 NA 0 NE DYes gNo DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~No DNA 0 NE 0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN> IO% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12. croptype(s) WCbJgl Beorwdtt Hay; Smallgralh OverJfflL 13. Soil type(s) _A~v::....:B~.L.:}s~--------------------------- 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable a cre determination ? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reviewer/Inspector Name Reviewer/Inspector Signature: Page 2 of3 DYes ~No DNA ONE DYes ~No DNA ONE DYes ~NoD NA D NE DYes ~No DNA O N E DYes f;j(No DNA ONE 12128104 Rev I ~~0, Nov~-' a'll> I 0 . I Fatottity Number:~~ -~'fl Date oflnspection I llJh~lf 0 I Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. D WUP D Checklists D Design D Maps D Other ~Yes 0No DNA ONE ~Yes 0No DNA ONE 21. Does record keeping need improvement? lfyes, check the appropriate box below. ~Yes D No DNA 0 NE i}a Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification D Rainfall D Stocking IE Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain 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 i':8"No DNA DYes 0No fR'NA DYes ~No DNA DYes ~No DNA DYes l'8J No DNA DYes DNo 18'NA DYes ~No DNA DYes ~No DNA DYes J!l No DNA DYes llJNo DNA DYes ~No DNA QYes 0No DNA }Cl.;},Srnall c:Us~e. (5(o~ St¥f) fron. ctrtlf' cf-pjhD'1e ~ fit J¥~dr ne~r7 cYtlln ()tyl GtJ!hft! S rvaMf a !JJ fll""'lfit by ~m Y\1~. W OJ f.e._ tt'Ps not-rRacA ~~ Svrf'o re_ yvcdfu 01 dp.ychaltt~. Mr, fWJ~salcl i+ hpJ bflfh !J o,c_, en~ O/J10"Pl tr~o, Crack httr l?ff-1 YYfY ~ft) O; ;11 pol+. PfeP-Je+rf"7 bdtl£ bvJhei frtm bockrik &f-ltyan /, Good IJ,trk th fttJ'f -fdmm!J ;;rf>-"L I '1jlJin I q. .:>. S rnal/Jvi!J nttr I~ 1 hiP J' fi 1/'fti l<,. GOld c~ a, I ~a:Jn ;:;>. ltl4-d{), 'Pito,e have ca:r; Pfl?J'Iff.~ a,J_ WPJ-ie Pta, avuf/a b/e i?r J}?J~-1-Jbn. ~(. Ple~e !ttrra..t?&r 1 Rfl~ fbr eacf, crof ~PPJI>) OYi ~II ~~ cor red-P-411 t11tl tlcl'el, PAw~YO fu-rye. Ct1J_ ;;l7S ttr c~oda./. Plehep()J+ Crof y/eldl. ~4, \v ;It net>t ca I i bra+t~ lJ P7J tJf J-€()r, ~~ w ,'ll nffl sf vrlye S Ll~ Or ~&n,-h'rn b/ lht! 1!1-y{JtJr, 03. Ff; II D w llf n ePr!ftl +a chtt it {)) Cl' t1 cit_ -A';< , Page 3 of3 12128/04 ONE ONE ONE ONE ONE ONE ONE ONE ONE ONE ONE ONE • Fac'itity No. fu-k I{!{ Farm Name bt \}y,fJ @.rud Date f {){I~//() Permit __ COC ___ _ OIC_ NPDES (Rain breaker PLAT Annual Cert } IM I I I Pop. Design Current Type Lagoon 1 2 3 4 5 6 7 Spillway _:tnn-l4 gd... Jf,of l'l Design freeboard II Observed freeboard (in) ~J ~h Sludqe Survey Date ....:::....; irilllflR Sludge Depth {ft) {(),!<) I "~ Liquid Trt. Zone (ft} ll:),qQ i3 lo.' Ratio Sludge to Treatment Volume 5r 1 ~iav..P Calibration Date 1l-l~IN 2 3 4 Design Flow ~ll'l Actual Flow ~ Design Width j.;r Actual Width 'Jhn Pull/Field Soil Crop Acres PAN j A,~ ~-1---~ Lq ;){} I~ I _)_) ~ LJ !t.J \,)f :..Y 1~.'1 SYl"l ,t'lnt, -6me_ lq;)\oAel "\ (h., 5"'" i" bcJ ra~11 Verify PHONE NUMBERS and affiliations 'f 9D Date last WUP F RO \-\\ir) Date last WUP at farm FRO or Farm Records ~ B"""'-. ~-,. ~09 Lagoon # ~ 1 v'VI'} ~ Top Dike )l\ J ff~ss Stop Pump tq W'l. Start Pump '-IJ '.J Conversion-Cu-I 3000= 108 lb/ac; Zn-1 3000= 213 lb/ac I 5 6 7 8 RAIN GAUGE Dead box or incinerator __ _ Mortality Re cords Wffdt~r~ 1 P.. rt d.. 's n {J(?(/ "-~ ( Window Max Rate Max Amt Htt"-St>t ·f OLh i , I ,)i,o.-A1r ~ ' App. Hardware tJ~to be-~~~ t~vf v f IS~ /iD~e. h6~ cvf-I q-h, Ha,berlJ-1-ttto·{ ~ o 11 Type of Visit ~Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit Q"Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access Date of Visit: IHI~DJlkf I ArrivaiTime:IJ; ll2/tf Farm Name: GtfM£1 Root!... fOterS I Departure Time: 'f);~DPfj I County: SamfJ(n Region: F,eo Owner Email: ------------- Owner Name: ---~..Hw-.L...;;.;...::::frt...J._ _________ ..,6='1-'t_m_eJ=--------Phone: Mailing Address: ------------------------------------,-,Tilf:tl;d.-rr_*d""d-1 ~--111J Physical Address:-------------------------------------7./:---- Facility Contact: JOm.Ps ~oesc6 Title: Hb<!ytt= Pbone No: Cfl'f 1jf-~tl {t} Onsite Representative: -::x.J~ FJefcJ, / Rlh GrfiJ1ti Integrator: Hvti~1-~0l'f} tt Certified Operator: Hfdvt£\ --''Q;...:::'/Y"""J"-*1"'-+------Operator Certification Number: M d.~ap} Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: D OD'D" Discharges & Stream Impacts I. Is any discharge observed from any part of the operation? Discharge origin ated at: 0 Structure D Application Field 0 Other a. Was the conveyance man-made? b. Did the discharg e reach waters of the State? (If ye s, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3 . Were there any adv e rse impacts or potential adverse impacts to the Waters of the State othe r than from a di sch arge? DYes ()INo 0 NA ONE DYes DNo DNA ONE DYes 0No DNA ONE I DYes 0No DNA ONE DYes l5iNo DNA ONE DYes (2{No DNA ONE 12128104 Continued ...,. '• j'F_a_ci-lit_y_N_u_m_b-er-:~-d---.....,{(;,....(p_'f.....,l Date of Inspection IJU20£09 I Waste CoUection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 0 Yes 5a'No 0 NA 0 NE 0 Yes 0No DNA 0 NE Structure 5 Structure 6 Identifier:------------------------------------- Spillway?: Designed Freeboard (in): _.:..,./ ~....:,__ ___ --"l:....q'----------------------------- Observed Freeboard (in): ___.,;;,..~&.u...._ ___ _..,~~0'----------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) DYes ~No DNA ONE 6. Arc there structures on-site which are not properly addressed and/or managed DYes N-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 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? &Yes DNo DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes ~No DNA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outs ide of Area 12. Crop type(s) Coo£1-o l Y3ttm..da Hay'. SmO Gtoln o_s 77 13. Soil type(s) bit.Y"II/e B ls 14. Do the receiving crops differ from those designated in the CAWMP? 15. Docs the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? rc:oilllmtelits !(refer' 'th:question #): Explain any ·Use drawiligs offadlity·to better explain Reviewer/Inspector Name Reviewer/Inspector Signature: .:.:i~l:if'~f;:i.il'7il~ any recommendations u.:>•;.~ .. ·~~~uuu ... pages as necessary): ' DYes ~No DNA ONE DYes !Sa No DNA ONE DYes D No 0 NA lSI NE DYes l:2i No DNA ONE DYes l){No DNA ONE Continued I Facility Number:'b d-. Wt.( I Date of Inspection II danIa? I Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. D WUP D Checklists D Design D Maps D Other 18Yes 0No DNA ONE ~es 0No DNA ONE 21. Does record keeping need improvement? Ifyes, check the appropriate box below. 5l'Yes D No 0 NA D NE Df'waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification 0 Rainfall 0 Stocking D Crop Yieid 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? DYes lSI-No DNA ONE -23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes DNo ~NA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes !)a No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~No DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes fgNo DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 0No ~NA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes i:fNo 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? Qf"No DNA ONE 30. At the time of the inspection did the facility pose an odor or air quality concern? DYes tiaNo 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 tiaNo 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 SNo DNA ONE 33. Does facility require a follow-up visit by same agency? DYes N"No DNA ONE 12128/04 .. F~cljity No~~(t,y Farm Name Gtf111-1 /<(X)J fu,y Date _____ _ Permit / COC --OIC ./ NPDES (Rainbreaker PLAT Annual 'cert} Pop. Design Current Type FB Drop~ /J fr110d ~~~UII't' I I 1-I t1•'" ·~ Tof Lagoon . 1 ! 3 4 5 6 7 Spillway Design freeboard Observed freeboard (in) ! Sludge Survey Date I Sludge Depth (ft) r~Urfot Liquid Trt. Zone (ft Ratio Sludge to Treatment Volume Calibration Date 10iallt8' 2 3 4 5 6 7 B Design Flow 300 Actual Flow ~~ Design Width J.,r Actual Width . 3po Soil Test Date ~ pH Fields " 1 Lime Needed {). ~ LimeAppl, Cu-I __ Zn-1 =:::__ Needs P l) Cro Yield RAIN GAUGE (_...../ Dead box or incinerator __ _ Mortality Records Wettable Acres , . WUP t.JFb'1f~il\ ~c-e_ Weekly Freeboard~-- 1 in Inspections -.,.- 120 min Insp. ;::::;;::>"' Weather Codes ;:::;::> Transfer Sheets· Pull/Field Soil · Crop Acres PAN Window Max Rate MaxAmt 1-lf ~.B Ct ~-lh ."L,q, 7" CJI) ~or-5ef Q.(p /.0 .56-~ 5o ,<;:.1-A ?i v u Verify PHONE NUMBER,S and affiliations Date last WUP FRO 1IJIIC/ Date last WUP at farm App. Hardware _ -r L. Qec 3l;}Jib; \1\& L 1. \~av~~ FRO or Farm Records ~ llJ'l '-llJ J Lagoon# -sqo ~or>ib(eJ~ sBCOtltr ~ ~~:p ~~~p ~t2 ~3.:3 wrrfo.-oat -StcoA/1-' ~' StartPump '-1~4> 4~·)/V7 t)1~ ~~.e. lO-IS~hf»t ~ Conversion-Cu-I 3000= 1 08 lb/ac; Zn-1 3000= 213 lb/ac l.... nt;-S f lc, .,~J,e /t,17 ) f O)l~\t\t. ~o (i " 1/J (\~ _l .bP ~~ S-=-1£-q'-f fo'ir~\tl&lt roukf~tvf~~~ -"w~~Q"-~ ~~ 1-~~ ~~~/ f''..,e{ .·, . -. . . . . ' -./ . ~ tlhl' 110) \b\0 _1qc $e ') ~ 1 <1'\~\ o -\\i J5l~ )f't bth --::>~ 4J~b!'Ji ~W\JjV~ ~1~ -rtf~CJ 1qi"J Vfl ~ oq h o-\ L-e, J -=* ~ ~ \() u jf ~tlll 'e-.:/tfrJfJ6JJ 'e l4wttJvcJ Ia It~ fOG • . ~ I Facility Number I ~ ?-. H ~.~.~11 Q Division of Water Quality 0 Di visio n of Soil and Water Conservation 0 Other Agency Type of Visit 0<:ompllance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Dat e of Visit : IIi: J~ Arrival Time : I~.:OCt.-!.:111,,):...:0~J¥l....,,,...._.l Departure Time : PI; I) !rf1 I County: StJttfS<!b ~egion : FflO Farm Name: 6t fhtf\ Rozd. Fi;tmJ Owner Email: _----::.\-----::---::; ______ _ Owner Name: --->.::tt~~.x...l._L _______ -'~'~-..u.~.:.~ ...... ~~J.'l__,;J""_r;...._ ____ _ Phone: Mailing Address: ---------------------------------------- Ph ysica l Address:---------------------------------------- Facility Contact: i~ Roesch Title: firm fi()f.~ Phone No: q1q 13"l-~fl.f3 Onsite Representative: ~ .... ._.lh'l""":..a.4_.__ .... ~ ....... ..,Mo.:...,,___________ Integrator: H Wf7l3ro .... h Certified Operator: t·flre t»t/tn Operator Certification Number: A~ :JEJ6/ Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD 'D " Longitude: D OD 'D " Design C urrent Design Current Design Current Sw in e Capacity Population Wet Poultry Cap acity Population Cattle Capacity Population r r:::ID::::--L-ay_e_r __ """T""" ___ r--__ ___, D Non-Layer ID Wean to Finish jg'wean to Feeder gg-36 5J/(b D Dairy Cow I D Dairy Calf i ~ F ceder to Finish Farrow to Wean ' D Farrow to Feeder 0 Farrow to Finish 0 Gi lt s 0Boars ; -~ -· ·-·-. --- D Dairy He ifc1 ' 0 DryCow ' D Non-Dairy I D Beef Stockel ; D BeefFeeder D Beef Brood Cow ' -. Dry Poultry D Layers D Non-Layers D Pullets : 0 T urkcys I Otber D T urkey Poults D Other [D Other Number of Structures: I~ .J 1 Discharges & Stream Impacts I . Is any discharge observed from any part of th e operation? D Y cs 6.d No D NA D NE Discharge origin ated at: D Stru cture D Application Fie ld D Other a. Wa s the conveyance man-made? DYes 0No DNA ONE b . Did the discha rge reach waters of the State? (If yes, notifY DWQ) D Yes 0 No DNA O NE c. What is the est imated vo lume th a t reached waters of the State (gall ons)? d . Does discharge bypass th e waste manageme nt system? (If yes , notify DWQ) D Yes 0 No DNA O NE 2. Is the re e vidence of a past di scharge from any part of the operation? D Yes Clf No DNA ONE DYes jgNo D NA O NE • ' 3. Were there any advers e impacts or potenti al adverse impa cts to th e Waters of the State other than from a discharge? 12128/04 Continued ~ Date oflnspection ha hbltlt 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? DYes ~o DNA ONE DYes DNo DNA ONE Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: _TiL:O~fr-3-____ &~~1-L.:-'-L-------------------------- Spillway?: --Jo.J~I..,~~-----2L"'"'---------------------------- Designed Freeboard (in): _....;:~=-::..:':.....L..-"f-lqL.-___ --.~lw'l~.-______________ ------------ Observed Freeboard (in):------------------------------------ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ISaN o DNA ONE DYes ~No DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 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? l)tYes 0No DNA ONE DYes ~o DNA ONE DYes DNo DNA ~NE ,. DYes QkNo DNA ONE 11. Is there evidence of incorrect application? Ifyes, check the appropriate box below. DYes D No ISCNA 0 NE 0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN > 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area 12 . Crop type(s) Coarfa lllfl=m.,b... -Hal ' S G> (H :J 13. Soil type(s) !..Au~uB!............IL...s~---------------------------- 14 . Do the receiving crops differ from those designated in the CA WMP? 0 Yes 15 . Does the receiving crop and/or land application site need improvement? D Yes 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? DYes DYes ~No 0No ~0 !)~No ~0 Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. Use drawings offacility to better explain situations. (use additional pages as necessary): · DNA DNA DNA DNA DNA If ~ Coo~'te.. ~.HO,jllCti>tfolftr-~o;b Ot) (jJCCCY~ ;, ~17"{)-y et"Oeld(lh~ ~i.-aft llctril'Qo? i.s Feb I 0. Tert iJ MKc.h r~. wetreJf /o(~ .CI'e.. rl41-ey~ ~ kflltn.S\Iilft .. ( ~ik 1J-fiOt!nt~toJef DIC cfr1f-HurhbN. · (E'JfJ~, no'ftJ (of-0., ~fti~LDfi] Reviewer/Inspector Name Reviewer/Inspector Signature: ONE 15lNE ONE ONE ONE 12128104 Continued j Facility Number: <5;). ~wy I Date of Inspection Ji I~ flblQ I Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check the appropirate box. D WUP 0 Checklists D Design D Maps D Other ~Yes DNo DNA ONE AlVes ~No DNA ONE JV) 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes D No D NA ISJ-NE D Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis D Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections D Weather Code 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Did the facility fail to conduct a sludge survey as required by the permit? 26. Did the facility fail to have an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? Other Issues 28. Were any additional problems noted which cause non-compliance of the pennit orCA WMP? 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 33. Does facility require a follow-up visit by same agency? Additional Comments and/or Drawings: DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes 12128104 ~0 DNA ONE 0No ~A ONE 0No DNA ~ 0No DNA DtNE lSiNo DNA ONE 0No i)lNA ONE ~0 D_NA ONE !»No DNA ONE ~No DNA ONE r8J No DNA ONE Da-No DNA ONE I3"No DNA ONE . . . Fa cility No . <b.>~' j Farm Name Date --------------------------- Per m it __ COC __ _ OIC_ NPDES {Rainbreak er PLAT Annua l Cert } POP . Type Desicm Current LaQoon Spillway Design freeboard Observed freeboard {in Sludge Survey Date SludQe Deoth {ft} & % Liquid Trt. Zone (ft) 1 2 Soil Test Date ___ _ pH Fields Lime Needed Ul k"""'1 Lime Applied C u ___ Zn ____!b)kr\OII'Y7 Needs P Waste Analysi s Date -60 Day + 60 Dav N Amt {lb/1000 Gal} pH Pull/Field Soil Crop 1\-Y l<r.t.k .5' r..~ -1 'Col A.lt3 IDR.Jab I ·~-- FB Drops v,IJIY' u,... 'U1 2 3 4 )q IQ ;t~ s-:t 3 4 5 Crop Yi eld n/a._. Wettable Acres ____ _ WUP Weekly Freeboard J'!L ~ Rainfall >1" ~D\-Sr7~"'- I RYE PAN Window :~/T .5eLf:&r -~n HJ!-~e)lf- v I 5 6 6 7 1 in Inspections . 120 min Inspections Weather Codes Transfer Sheets RAIN GAUGE Max Rate ().{o fl.·" Ver ify PHON E NUMBERS and affiliations J) 07 Date last WUP FRO 4t ( Date Ia* W~ at farm A p p. Hardware FRO or Farm Re cord s /1'11'\fl~ yr:O ~....- Lagoon# I "tO)<: ¥fo IS) T op Dike S"O·G 500 Stop Pump ~.,.oo=~~ ~l3C ~~4 ~ ~tart Pump 41 ,)"f ~~ 0 l!} ~ ~~.} 4£'1~.,~~ ~' ee&_~clta!c.neJc.. ~vf -tlof4-lt'lH k, 'J I 7 8 Max Amt I" 1\1'-1 ,, I ~acility Number l~ ~ H -''lJ. II -R Division of Water Quality 0 Division of Soil and Water Conservation 0 Otber Agency ·-.' Type of Visit ~Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit i'[Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access ~1'11-tJif\' DateofVisit: ll:)h) JOJ I ArrivaiTimedl~~'fS"Pf11 DepartureTime: f"''-~.'11 County: Sa., lUh Region: rPO Farm Name: ROn GriMtJ H(IJ7 Owner Email: ------------- Owner Name: ~Oa Grfme.r . VOaJ es Roesc.b Mailing Address: $ '-13 D Sv:lh, Jb~ oJ 7 ; Physical Address:---------------------------------f'Wt~7':"1--=::::::aon-ri"l~.,...... Facility Contact: ~Om¢ Roesch Title: Co-own'ft Phone No:ClR ~q,;{ftc; Oosite Representative: J'o.,eJ Roesch q.. Qp, Gr brt.J Integrator: .....:....;H:...;.~oo~~rfF-=h~1~1J~rO::..:..;_it'<...:.n _____ _ Certified Operator: HI choef Oorr.J.ea ----------Operator Certification Number: ~3~ ~ I ' . Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD 'D " Longitude: D OD'D" Design Current Design Current Swine Capacity Population Wet Poultry Capacity Population 10 Layer 0 Non-Layer Dry Poultry 0 Laye rs 0 No n-Layers 0 Pull ets D Turkeys Other . 0 Turkey Poults 0 Other ID Other --. Discharges & Stream Impacts I. Is an y discharge observed from any part of the operation ? Discharge origi nated at: 0 Structure 0 Application Field 0 Other a. Was the conveyance ma n-made ? b . Did the di sc harge rea ch wa ters of the State? (If y es, noti fy DWQ) - Design Current Cattle Capacity Population 0 Da irv Cow I 0 DairvCalf I 0 Dairy Heife1 I I 0 DrvCow D Non-Dairy . _i D Beef Stocker I D Beeffeeder i D Beef Brood Co\\ I -·-. ·----------····- Nu~ber of Structures: I ~J u-vJ lives <c~ t(tlll-ittSftt~·tj , EJ No DNA O ·NE DYes 0No DNA ONE DYes 0No DNA ONE c. Wh at is the estimated volum e that reached waters of th e State (gallons)? d . Do es discharge bypa ss the waste management system? (If yes, noti fy DWQ) 2. fs there evidence of a past di sc harge from any pan of the opera tion ? 3. Were there any adverse impacts or potential adverse impacts to the Wat ers of th e State other th a n from a disc harge? D Yes 0 No riJ Yes 0No DYes lSlNo 12118104 '•. DNA O NE DNA ONE DNA ONE Continued Date of Inspection ll~lflJD7 I Waste Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. lf yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: Vff' r lotvfl: Spillway?: DYes 'b(tNo 0 NA 0 NE DYes 0No DNA ONE Structure 5 Structure 6 Designed Freeboard (in): dO CJI~ b_,a"""-'o::;..._ _______________ ------------ ObservedFreeboard(in): ;a+ _...,515~--------------------------- 5. Arc there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, e tc .) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes D(JNo DNA ONE DYes ~No DNA ONE If a ny 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? g'" Yes 0 No 0 NA 0 NE 8. Do any of the stuctures lack adequate markers as required by the pennit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Docs 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 alternative s that need maintenance/i mprovcment? DYes ~No DNA ONE DYes liJNo DNA ONE DYes 0No DNA ~NE 11. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes D No DNA m NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN> 10 % or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside owceptable Crop Window 0 ~f e of Wind Drift D Application Outside of Area :: ~~:,p:~;> h ~&yJww ~m;JA1Wy-~ 14 . Do the receiving crops differ from those designated in the CA WMP? DYes 0No DNA l)il NE 15 . Does the receiving crop and/or land app li cation site need improvement? 0 Yes D No 0 NA ~ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre dctennination?D Yes }E No 0 NA II NE 17. Does the facility lack adeq uate acreage for land application? 18 . Is there a Jack of properly operati ng waste application e quipment'? DYes 18No DNA ONE DYes 0No DNA liNE Comments (refer to question#): Explain any YES answers and/or any recommendations or any other comments. Use drawings of facility to better explain situations. (use additional pages as necessary): ' Reviewer/Inspector Name Re\'iewer/lnspector Signature: Date: lZ/28/04 Continued .. I Facility Number: 8 d., -6~YI Date oflnspection It (;;dtaJOlOD/ Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropirate box. D WUP 0 Checklists 0 Design 0 Maps 0 Other DYes 5lNo DNA ONE DYes (XNo DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. ~Yes 0 No DNA 0 NE D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers D Annual rertification D Rainfall D Stocking D Crop Yield D 120 Minute Inspections ~Monthly and I" Rain Inspections 0 Weatller 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? Additional Comments and/or Drawings: ~Yes 0No DNA ONE DYes 0No ~A fdNE ~Yes DNo DNA ONE DYes 0No fjlNA ONE DYes ~No DNA ONE DYes 0No ~NA WNE DYes Ill" No DNA ONE DYes ti(:1 No DNA ONE DYes KINo DNA ONE DYes ~No DNA ONE DYes l&fNo DNA ONE DYes RfNo DNA ONE ~~I! {'tQ, ithlt liP n&r lo~ver h~V.>f. Tl.ln~ ~>-a.r cal(r.tL ~Jslldf-~M.~ /e11~ ... - 7. ~ tifr ~!)}-Ple..re.. remove.. 5flli-tl'l'e fr0n1 ~ iJ~ "'J It'"' ,,e '(q-h lm;J~ ~I( VW3~ . t~ r;r-~ ~s;de_ ~~ ~o.se. ~"ill t it..fd f-&e/ comeJ~ below o~'lfftl (lc.rr~ lit-of~ s/o.-'{je ~~~t~l<.) l..owtr '~.., FHI eroliOn rills io Sw C!Xtlfr Ovl.eJhtbliJh co~er fn--thal-~t"t'a.. , seetf~ t».drtt,lcA!:J, .Pielle. cvt br0h7h/es ond~'a, 1t'Or1 D-trlde_bank dl, ~~cwh{:atfc ofu.,~ ~...-l:fle "'~"'6\i-fi~N) ~oo7, klewwtble.f1elcL Pl.!JS stodoeJ... Sl'f <!OU7 , Not-~ r'follilt! &-se.,.,~ ~ ll". LY,001I h4"1' ~ ~~ llttl" f. . lte ~ ~1m~ ,., ~ 'ltu-'14/W. et.-!Jr :)(x~ • h-it 'leeLSoil Atla~su a.;.! IY11.ik ~su b e ff 1f./ll"4iio-,, ,anv;l( ned sl1f_ ~lit 1', dOot I 0¥&-1~~ fllli'i /J b ufty-11 f(tr I~ ~. hoil/ netJ... :k~ f"-«"Fulfwtfa, ~ !f'l' tJffll 'tn NteL. -to~ tl far'IJ ~a~. 1--..... 12118104 Mr. Ron Grimes 8430 Suttontown Road Faison NC 28341 Dec 17,2007 Dear Mr. Grimes. Michael F. Easle y, Governor Will iam G . Ross Jr .• Secretary Nonh Carolina Department of Environment and Nat ural Reso urces Coleen Sullins . Director Divi sion of Water Quality I appreciate all the hard work and money that has gone in to putting your farm back in production . S ince you have not been operational for several years , some of your paperwork is outdated . These particular items have to be changed in Raleigh , so please mail your forms there. It would also be a good idea to send me a copy in Fayetteville at the address below. 1-Please fill in the Operator-In-Charge Form. I was told that this is Michael Darden, License# 28261 but I cannot make this change. Mr. Darden is a legitimate OIC, but as of now not officially listed for your farm. Please note that the OIC is responsible for registering annually with our certification commission plus obtaining 6 hours of approved continuing education credits every 3 years . Also note that this form is mailed · to a slightly different address (1618 Mail Service Center, Raleigh) than the item below. 2-We also need a change of integrator form. Our current listing is "independent". I was told that Murphy- Brown is now your integrator, and again I cannot make this change. This is mailed to 1636 Mail Service Center, Raleigh . I added Mr. Roesch as co-owner, as per my conversation with him . However, the official paperwork is still going to your address as owner. Please let me know if either of theses statements needs to be changed. Enclosed is an IRR2 form for recording spray events. Th is is also available on the web at as an Excel spreadsheet at http://h2o.enr.state.nc .us/aps/afou/afou_home.htm und e r "Reporting Forms". I do not remember whether you had these or not. I am enclosing a typed co py of my corrected inspection. I made one major mistake in checking item 1 "yes" instead of "no" and there are some other slight changes. I am informed that Murphy-Brown is pretty strict about checking that inspection "yes" items are corrected, so that will be one less thing you have to explain to them . Also, in talking about work on your upper lagoon, I mixed up the east and west sides, although you probably understand what I meant. I did not explain the rain gauge situation well during the inspection. One should be installed in the near future. even though you are not pumping . Preferably it should be somewhere convenient to read and in the open not very close to roof, tree, power line or any other kind of over hangs, nor subject to splash . It needs to be read and recorded after each 1-inc h rain event and no less than on ce monthly. Most people read and keep the rain and lagoon levels together on one form, often on a calendar with multiple months per page . The lagoon level must be read weekly. I failed to inquire if you had sludge cleaned out of your lagoons while they were down. If so, you should keep that paperwork with your other farm records , have sludge surveys done in 2008, and then appeal for "N'ifrth carolin a .Naturall!f No rth Carolin a DWQ/Aquifer Protection Sectio n 225 Green St./ S uite 714 Fayetteville . NC 28301 Phone (91 0) 433-3300 FAX (910) 4!!6-07 0 7 Internet: h2o .enr.state .nc.us Customer Serv ice 1-877-623-6748 An Equal Opportunity/Affirmative Action Employer -50% Recycled/10% Post Consumer Paper .. couple year exemption from surveys. Even if the lagoons were not cleaned out, you can appeal for an exemption if sludge levels are low and liquid levels high. You will probably find that there is currently a bit more paperwork and requirements are somewhat stricter than they were a few years ago. That is just part of doing business in today's environmentally conscious society. Since you have not been in operation for a while, it would also be a good idea for you to review your permit. Please do not hesitate to call me at (91 0) 433-3333 if you have any questions. Sincerely, Joan Schneier Attached : OIC form Change of Integrator form IRR2 Revised inspection Cc: Mr. James Roesch (no attachments) fRo fll~ Type of Visit 8 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit 8 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access DateofVisit: ~~·Zi'-P~I ArrivaiTimedz:o' h .... l DepartureTime: 12~ lsJ.S AJ County: $0eragAL Region: Eb r r , Farm Name: /2.o N C.O!Me S' F'4 v M. Owner Email: -------------- Owner Name: ___ ---~:R:::.~.o~l'l:=...... _____ -'""G""'n~· ~ryt.ag...,G""".S.""-------Phone: Mailing Address: ----------------------------------------- Physical Address:----------------------------------------- Facility Contact: N.s Bar~-Eko +--Title: Sls -kv-Phone No{ 'flo) 59'1/-BoY Onsite Representative: -------------------Integrator:---------------- Certified Operator:--------------------Operator Certification Number: -------- Back·up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts l_ Is any discharge observed from any part of the operation? 0 Yes ~No DNA ONE Discharge originated at: D Structure D Application Field 0 Other a. Was the conveyance man·made? b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d_ Does discharge bypass the waste management system? (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 impact s to the Waters of the State other than from a di s charge? Pagel of3 DYes ~No DNA ONE DYes 0No ~NA ONE I DYes 0No ~NA ONE DYes [1}No DNA ONE DYes ~N o DNA ONE 12128/04 Continued I Facility Number: ~z-~btl Date oflnspection ~-Zf-0 4- Waste CoUection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. lfyes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure4 DYes ~No DNA ONE DYes [21No DNA ONE Structure 5 Structure 6 Identifier: 70p UJDD""-&&,.. 'f'm.I·------------------------ Spillway?: Designed Freeboard (in):--------------------------------------- ""'~o"' ~ ~o 'I Observed Freeboard (in):_-_,.!!!_"'-""'-------'~:........::'--------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/large trees, severe erosion, seepage, etc.) DYes [»No DNA ONE 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes QtNo _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 stuctures lack adequate markers as required by the pennit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? 0 Yes O"No 0 NA D NE DYes ~o DNA ONE DYes (]?No DNA ONE DYes O}No DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ISI'No 0 NA 0 NE D Excessive Ponding 0 Hydraulic Overload 0 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 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area 12. Crop type(s) ---L~"""'==---------------------------------- 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CA WMP? DYes (8No DNA ONE 15. Does the receiving crop and/or land application site need improvement? DYes [»No DNA ONE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? DYes ~NoD NA 0 NE 17. 18. Does the facility lack adequate acreage for land application? Is there a lack of properly operating waste application equipment? to question #): Explain any.yE·s;~*sw~rs.jiid/or any re<:onlm,encJatiolll~. ra,lfiD!is'lof facility to better explain situations~:(us~ llddi_tional pages as nel~essa•:y):')'.;:.f Reviewer/Inspector Name 1 ~~~~~~~~~~~------------------~· Reviewer/Inspector Signature: Page 2 of3 DYes ~No DNA ONE DYes ~No DNA ONE Date: 12128104 Continued I Facility Number: <?z -k?iJ Date of Inspection 1~-Zf-t>,kl Required Records & Documents 19 . Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box . 0 WUP D Checklists 0 Design D Maps D Other DYes rlJNo DNA ONE 0 Yes ltJNo 0 NA 0 NE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes Q!'No DNA D NE 0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and I " Rain Inspections 0 Weather Code 22 . Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equi pm ent? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Did the facility fail to conduct a sludge survey as required by the permit? 26. Did the facility fail to have an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? Other Issues 28. Were any additional problems noted whi ch cause non-compliance of the permit o r CA WMP? 29. Did the facility fail to properly di spose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? 30. At the time of the inspection did th e fac ility pose an odor or air quality conc ern ? If yes, contact a regiona l Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site represen ta tive ? 33. Does facility require a follow-up visit by same agency? Ad.dltioitaf ·Comnieiit~:~n dJor Drawings: Page3 o/3 DYes ra'No DNA ONE DYes OJINo D NA ONE DYes [HNo DNA ONE DYes [)No DNA ONE DYes Of No D NA ONE DYes ~No DNA ONE DYes OJ!No DNA ONE DYes ~No DNA ONE DYes QfNo DNA ONE DYes ~No DNA O N E DYes (2PNo D NA ONE DYes l;i(fNo DNA ONE ·~·~;~S.:~~~~,J;~.:~~;~~ ..... ,..._ -... 12118104 e Compliance Inspection 0 Operation Review 0 Lagoon Evaluation Reason for Visit e Routine 0 Complaint 0 Follow up 0 Emergency NotifJCB.tion 0 Other D Denied Nx;ess '-___________________ _.I Date of Visit: '-~;:;:==!Ti:.:un=e:~l==::;::;::~~--~""'1 Facility Number I B2_ H ft.tt · · lo Not Operational 0 Below Threshold I&J1»ermitted C Certified C ConditionaDy Certified C Registered Date· Last Operated or Above Threshold: Farm Name: __/fp.Ll. 6r,'m q FarM County: $a~ r£ 0 Owner Name: __ _£.1!.l!._ ~_u,<.S ·Phone No: Cf I 0 -,£9'1 -fl3 3 Mailing Address: __ ~ '1 J.Q_ _ _.?vtfflt':L!.IJ.I6I.n. __ l(f2oJ _E~ ~.., NL. :2 8,1. ':t/ -·---__ _ Facility Contact: Title: ·-------------------PboneNo: -------------------- Onsite Representative: -------------·----~wr. JCae'~na?~t: _______ __ Certified Operator: ________ ----OpendOrC~amooNumber. ______________ _ I...ocation of Farm: Discharges & Stream Jmpacts 1. Is any discharge observed from any part of the operation? D ischarge originated at: D Lagoon 0 Spray Field 0 Other a. If discharge is observed. was th e conveyance man-made? b . If discharge is observed, did it reach Water of the State? (If yes, no tify DWQ) c . If discharge is observed, what is the estimated flow in gal/min? d . Does discharg e bypass a lagoon system? (If yes, notify DWQ) 2. Is there evidence of past discharge from any part of the operation? 3. Were there an y adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Waste Collection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? 0 Spillway Structw-e I Suucture 2 Structure 3 Structure 4 Structure 5 Identifier: ------· ----- DYes [i}N"o DYes 0No DYes DNo DYes DNo DYes DNo DYes DNo DYes DNo Structure 6 Free board (in ches): -------------------------------------- 12112103 Contimud Date oflnspectioo JJ,? · k o7 I 5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, seepage, etc.) 6 . Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7 . Do any of the structures need maintenancef1mprovement? 8. Does any part of the waste management system other than waste strUctures require maintenance/improvement? 9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level elevation markings? Waste Application 10. Are there any buffers that need maintenanceflDlprovement? 11 . Is there evidence of over application? If yes, check the appropriate box below. 0 Excessive Ponding 0 PAN 0 Hydraulic Overload 0 Frozen Ground D Copper and/or Zinc 12. Crop type 13. Do the receiving 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? Odor Issues 17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below liquid level of lagoon or storage pond with no agitation? 18. Are there any dead animals not disposed of properly within 24 hours? 19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring veg etation, asphalt, roads, building structure, and/or public property) 20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. Fa'"" Renewerllnspector Name Reviewerllnspector Signature: 12112/03 Date: /. DYes ONo DYes DNo DYes ONo DYes ONo DYes ONo DYes DNo DYes DNo DYes ONo DYes DNo DYes DNo DYes 0No DYes 0No DYes 0No DYes ONo DYes ONo DYes 0No DYes ONo Dau of luspec:tion I J.2 ·t -<J '1 Required Records & Document.-; 21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? 22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available ? (ie/ WUP, checklists, design, maps, etc.) 23 . Does record keeping need improvement? If yes, check lhe appropriate box below. D Waste Application 0 Freeboard 0 Waste Analysis 0 Soil Sampling 24 . Is facility not in compliance with any applicable setback criteria in effect at the time of design? 25 . Did the facility fail to have a actively certified operator in charge? 26. Fail to notify regional DWQ of emergency situations as required by General Permit? (iel discharge, freeboard problems, over application) 27. Did R.eviewerllnspector fail to discuss reviewfmspection with on-site representative? 28. Does facility require a follow-up visit by same agency? 29. Were any additional problems noted which cause noncompliance of the Certified A WMP? NPDES Permitted Facilities 30. Is the facility covered under aNPDES Permit? (If no, skip questions 31-35) 31 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 32. Did the facility fail to install and maintain a rain gauge? 33. Did the facility fail to conduct an annual sludge survey? 34. Did the facility fail to calibrate waste application equipment? 35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. 0 Stocking Fcnm 0 Crop Yield Form 0 Rainfall 0 Inspection After 1" Rain 0 120 Minute Inspections 0 Annual Certification Fonn 12112/03 DYes 0No DYes DNo DYes 0No DYes 0No DYes 0No DYes 0No DYes 0No DYes 0No DYes ONo DYes ONo DYes 0No DYes 0No DYes ONo DYes DNo DYes DNo_