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HomeMy WebLinkAbout820672_INSPECTIONS_20171231NORTH CAROLINA Qepartment of Environmental Quality Date of Visit: [ 2-r/!8r Arrival Timed 51:.' J-r.> I Departure Time:l //.' oO J County:~~ Region: nO Farm Name: I<JI /) / a.rne Owner Name: Mailing Address: Physical Address: liPj ra.rYk.,._. /L!J It-a rn :( Owner Email: Phone: Facility Contact: /(·, m... /..4..../ ·.II ia.YYt5 Title: ---""'8='Lv::....:...;tt-=~=r ____ _ Phone: Onsite Representative: Integrator: Certified Operator: Certification Number: Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts 1. Is any di sc harge observed from any part ofthe operation? DYes~ DNA ONE Discharge originated at: 0 Structure 0 Application Field 0 Other: a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes , notifY DWR) 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) 2. Is there evidence of a past discharge from any part ofthe operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a di scharge? Page 1 of3 DYes DYes DYes DYes DYes 0No DNA ONE 0No DNA ONE 0No DNA ONE ~0 DNA ONE s<o DNA ONE 21412015 Continued "I Facility Number: ~-{, 2 2.._ loate oflnspection: Z-::5-;-.ib JJt" .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: 7-, TZ_.2_ ~2.· Spillway?: I< I Designed Freeboard (in): /7-/9-L2 Observed Freeboard (in): ~'7 '1.3 ~ 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 DYes~ DNA ONE DYes ~o DNA ONE If any of questions 4-6 were answered yes, and tbe situation poses an immediate public health or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? ~ ~-0 NA 0 NE 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~o DNA ONE DYes ~ DNA ONE 0 Yes 12f'No 0 NA 0 NE 11. Is there evidence of incorrect land application? Ifyes, 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 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 0 Application Outside of Approved Area ::-~:PT:;::)= :_~i~dn~~~;nv-./.._ zQv~~r=~ [2fN'o 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? l 7. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. 0WUP Dchecklists 0 Design 0 Maps D Lease Agreements 21 . Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes DYes DYes 0 Yes 0 Yes 0 Yes 0 Yes Oother: DYes ~0 ~ 01io [31fo ~ ~ 01io DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 0 Waste Application D Weekly F reeboard 0 Waste Analysis 0 Soil Analysis 0 Waste T ransfers 0 Weather Code 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~ 0 NA 0 NE 23 . If selected, did the faci lity fai l to install and maintain rainbreakers on irrigation equipment? DYes ~ 0 NA 0 NE Page 2 of3 214/2015 Continued "!Facility Number: W:-b 7.7-loate of Inspection: i' 7-_s-::r-R'I 24. Did the facility fail to calibrate waste application equipment as required by the pennit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. DYes DYes [3'No DNA ONE DNA ONE 0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels 0 Non-compliant sludge-levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Application Field D Lagoon/Storage Pond D Other: 32. Were any additional problems noted which cause non-compliance of the 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? Revi ewer/I ns pector Name : ... 7',"2)0::--~ ~ Revi-ewer/I nspector Signat ure: ~ ;;# Page3 of 3 DYes ~0 DNA ONE DYes [3""No DNA ONE DYes ~0 DNA ONE DYes ~0 DNA ONE DYes ~0 DNA ONE 0 Yes ~ DNA ONE DYes ~ DNA ONE \ DYes @'No DNA ONE DYes E}"No DNA ONE or any other Phone : ~--5 D 3 -<Jt5 ( Date: 2--:L~y- 21412015 Date ofVisit:l z;_ v--1/t Arrival Time:l /0 /t,l£1 Departure Timed /d: 0 0 I County:~Region: Owner Email: Owner Name: Phone: Mailing Address: Physical Address: Facility Contact: _ ..... f1_._=-~ ~w""'--""L< ... J:.......o..~ ._.l(._.;._tt..=r4t....._.$....._ __ Title: t9w n ~r Phone: Onsite Representative: 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? 0 Yes ~No Discharge originated at: 0 Structure 0 Application Field D Other: a. Was the conveyance man-made? 0 Yes 0No b. Did the discharge reach waters of the State? (If yes, notify DWR) 0 Yes 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. ls 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 ~No DYes ,®.No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 21412015 Continued ~'!Facility Number: f(; -{e Z?= I !Date of Inspection: (:, -~ -201;J •• Waste Collection & 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 l Structure 2 Structure 3 Structure 4 Identifier: ~l !<Z:J-72..3 Spillway?: Designed Freeboard (in): /9 /9 /9- Observed Freeboard (in): ~21 ~3)_ 3o 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DNA ONE D Yes D No 0 NA 0 NE Structure 5 Structure 6 DYes ~o DNA ONE 0 Yes ltJ-No 0 NA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate pubHc 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 l 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~No DNA ONE D Yes jig No 0 NA 0 NE 0 Yes ,®-No 0 NA 0 NE D Yes 1'2J-No 0 NA 0 NE II. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. 0 Yes gNo 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 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): 13. Soil Type(s): 14. Do the recei ving crops differ from those designated in 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reguired Records & Documents 19 . Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. 0 WUP Ochecklists 0 Design 0 Maps D Lease Agreements DYes ~No DNA ONE DYes ~No DNA ONE DYes Ga. No DNA ONE DYes J:8tNo DNA ONE DYes ~No DNA ONE DYes :f8-.No DNA ONE DYes ~No DNA ONE Oother: 21. Does record keeping need improvement? Ifyes, check the appropriate box below. DNA 0 NE DYes ~No 0 Wa ste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code 0 Rainfall 0Stocki ng D Crop Yield 0120 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 th e facility fail to install and maintain rainbreakers on irrigation equipment? Pagelof3 0 Yes~ No 0 NA 0 NE 1/411015 Continued • I Facility Number: I nate of Inspection: d; -i. -m/?i t 24. Did the facility faiJ 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 0-No DNA D NE DYes ~No DNA ONE 0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notifY the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. D Application Field D Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 33. Did the Reviewer!lnspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? Reviewer/Inspector Name: Reviewer/Inspector Signature: Page3 of3 DYes [2S.No DNA ONE DYes ~No DNA ONE DYes ~No DYes (2g..No 0 Yes g}_No DYes ~No 0 Yes (@No DYes g}.No DYes 0-No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE .. ~ ··:~ ~-·:.~. :~~ -: • • I ~. "'<II _., '"'IC Phone: ~tJ~3o3-tJJ5/ Date: ~ ...... L __. ?tJ 17 214/1015 Date of Visit: Jl$5-/k Jld Arrival Time: I ,1!): '3 iJ I Departure Time: I /;;L.'o 'V I County: .5~ Region: Owner Email: Owner Name : Phone: Mailing Address: Physical Address: Facility Contact: 1\ I "h..-'U/1' // ( «! ~ $ Title: Phone: Onsite Representative: ---'_5.~~===~=-------------Integrator: 2/n,--tfrr~l~ Certified Operator: ,1...------ Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream lmoacts l. Is any discharge observed rrom any part of the operation? DYes r8kNo Discharge originated at: D Structure D Application Fie ld D Other: a . Was the conveyance man-made? DYes 0No b. Did the discharge reach waters ofthe State? (If yes, notifY DWR) DYes 0No c. What is the estimated volume that reached waters of the State (gallons)? d. Does the discharge bypass the waste management system? (If yes, notifY DWR) DYes 0No 2 . Is there evidence of a past di scharge 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 ,(2g__No D Yes ~0 DNA ONE DNA ONE DNA O NE DNA ONE DNA ONE DNA ONE 214/1015 Continued • !Facility Number: tr-&ze: I IDate oflnspectioo: ?:-/l-£tlrbl •• ·t Waste CoUectioo & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) le ss than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure2 Structure 3 Structure 4 Identifier: Rl Z.Z-/:J.3 Spillway?: Designed Freeboard (in): /.t Lcr L~ Observed Freeboard (in): /25 2£:. s3 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 0NA ONE 0 Yes 0 No 0 NA 0 NE Structure 5 Structure 6 DYes ~No DNA ONE DYes l}?lNo 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 1. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the pennit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes i:El-N o 0 NA 0 NE 0 Yes QJ:._No 0 NA 0 NE DYes ~No DNA ONE DYes ~No DNA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~o 0 NA 0 NE 0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN D PAN > 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area 12. Crop Type(s): 0;/rJ, jd_.;;l-/ ¥~£ /lh:-rm&L./a U-r-/J ~/ 13. Soil Type(s): Mch! Is / Atv-h;z v;Jfr· 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 fai l 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 t he facility fail to have all components of the CA WMP readily available? If yes , check the appropriate box. 0WUP O checkli sts 0 Design 0 Maps D Lea se Agreements 21. Does record keeping need improvement? Ifyes, check the appropriate box below. DYes 0 Yes DYes DYes DYes DYes 0 Yes Oother: DYes J29--No D NA O NE ~No DNA ONE IKJ No DNA ONE (Z}-No DNA ONE 5:§ No DNA ONE ~No DNA ONE !JaNo DNA ONE ~No DNA ONE 0 Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers 0 Weather Code 0 Rainfall D Stocking D Crop Yield D 120 Minute Inspections D Monthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes Ji(] No 0 NA 0 NE 23. If se lected, did the faci lity fa il to install and maintain rainbreakers on irrigation equipment? 0 Yes ~No 0 NA 0 N E Page 2 of3 214/2015 Continued • jFacili!l: Number: fa.-CRZ?-1 I Date oflnsl!ection: 3'"-Zt-~Jbl • , • 24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes ~0 DNA ONE 25 . Is th e facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes baNo D NA O NE the appropriate box(es) below. D Failure to complete annual s lud ge survey 0Failure to develop a POA for s ludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26 . Did the facility fail 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 nonnal? 29. At the time of the inspection did the facility pose an odor or air quality concern? lfyes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency s ituations as required by the permit? (i .e., discharge, freeboard problems, over-application) 31 . Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Application Field 0 Lagoon/Storage Pond D Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP ? 33 . Did the Reviewer/Inspector fail to discuss review/i nspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of3 DYes .SNo D NA ONE DYes ~No DNA ONE 0 Yes jgl_No DNA ONE DYes 0No DNA ONE DYes ~No DNA ONE 0 Yes ~No DNA ONE 0 Yes J&l No DNA ONE 0 Yes ~No DNA ONE 0 Yes ~0 DNA ONE Phone : ~?L-§.:f-_3.3oD Date: &-/1-2--t?/? 214/2015 for Visit: Denied Access Date of Visit: I 7-;t?=:/Jl Arrival Time: I crt <oO Departure Time:! /D!DO I County=..,~ Region: Farm Name: U/; J/j aers Ho-J'< Ori'V'- OwnerName: J<T .It// 1/;a-.-,.t. Mailing Address: Owner Email: Phone: Physical Address: ----------------------------------------------------------------------------------- Facility Contact: _Lx_· J.&;_~ __ .....:W~eo:....J)~\wl .... -~..:., -=~..c::::...::$::.___Title: RWh ~,.-Phone: Onsite Representative: .. ~ Integrator: ...,,ia2.~·,c...s.._P~--------- 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? 0 Yes Q9._No DNA ONE Discharge originated at: 0 Structure 0 Application Field 0 Other: a. Was th e conveyance man-made? DYes 0No DNA ONE b. Did the discharge reach waters of the State? (If yes, notify DWR) DYes 0No DNA ONE c. What is the estimated volume that reached waters of the State (gallons)? d . Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No DNA ONE 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page 1 of3 DYes DYes ~0 DNA ONE ~0 DNA ONE 114/1014 Continued JFacility Number: ft;;--lo t;:LI I Date of I ospection: 7-t?l-r IS Waste Collection & Treatment . 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) Jes s than adequate? ~ a. If yes, is waste level into the structural freeboard? Structure 1 Structure2 Structure 3 Structure 4 Identifier: ':bi ~;J_ ~') I Spillway?: Designed Freeboard (in): LCf L? L?.. Observed Freeboard (in): £.,? 3S 31._ 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 fig.No 0 NA 0 NE DYes 0No DNA ONE Structure 5 Structure6 DYes .29-No DNA ONE 0 Yes ~ No D NA 0 NE If any of questions 4-6 were answered yes, and tbe 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 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 or improvement? 0 Yes ~No D NA 0 NE DYes gNo DNA O NE DYes ~No DNA ONE DYes ~No DNA ONE 11 . Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes BNo 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy M etals (Cu, Zn, etc.) 0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acce ptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. CropType(s): CD/'nfd-J(f;~$/75conJ~ /&v~~/ tlo cdi:>/1<.. I f/:1,.(~-')' llill t!:-13 . Soil Type(s): 14 . Do the receiving crops differ from those designatei:l in theCA WMP? 15 . Does the receiving crop and/or land application s ite need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? Page 2 of3 0 Yes g No 0 Yes ~N o DYes ~No 0 Yes SNo 0 Yes ~No DNA ONE DNA ONE DNA ONE QNA ONE DNA ONE DNA ONE DNA ONE 214/2011 Continued ,_ ~cility Number: I Date of Inspection: ?-n-IYI 24. Did the facility fail to cahbrate waste application equipment as required by the permit? • 25 . Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. DYes ~o DNA ONE DYes (g..No 0 NA 0 NE 0 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 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 c oncern? If yes, contact a regional Air Quality representative inunediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) DYes (iiNo DYes [3_No DYes Qr..No DYes 62J No DYes 1:8,.No 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes ~No 0 Application Field 0 Lagoonl~torage Pond D Other: __________ _ 32 . Were any additional problems noted which cause non-compliance of the permit or CAWMP? 33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? DYes ri1_No DYes G8lNo 0 Yes ~No '.~>£,;:) .. <1o5wen and/or any additional recommendations.or any other, as :;>t;.,.;:f.'·:·. ·· ·.· DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE Reviewer/Inspector Name : Reviewer/Inspector Signature: Phone : cpR:!{JY-:sJDO Date: 7---.n=z-;@~ • Page3 of3 21412011 ompliance Inspection Operation Review 0 Structure Evaluation Reason for Visit: Q-R.outine 0 Complaint 0 Follow-up 0 Referral 0 Emergenc 0 Other Date of Visit: 11¥-vl'l I Arri~al Time: I I ', Vt? I Departure Time: 1;2\ ! ) Z: I County: 5.~ £zc--Region: F~O Farm Name:_ ........ M:::.....:.'..LO.c..'l~i::.~..=..=...;;oiL...-...---LM~"P~'2-r:::......___,6'--.;;.."i?....:;.r'....;;,...,._~=------Owner Email: p Owner Name: ;u,~ II; ~m.$ Phone: Mailing Address: PhysicalAddress: ---------------------------------------------------------------------------------- Facility Contact: --"'"It_.:....;_; ....;l')t.. ___ u ... l"""";:..o:!'J_,__I:..;o-....;;.;;o"""$'----Title: Ptvn,...,., Phone: Onsite Representative: Integrator: --L01.L-!-_..;;:.i2~------------------ Certified Operator: Certification Number: / .!r"'J-7 • Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts I . Is any discharge observed from any part of th e operation? DYes ~No DNA O NE Discharge originated at: 0 Structure 0 Application Field 0 Other: a. Was the conveyance man-made ? 0 Yes 0No DNA ONE b. Did the discharge reach waters of the State? (If yes , notify DWQ) DYes 0No DNA ONE c. What is the estimated volume that re ached waters of the State (gallons)? d. Does the discharge bypass th e 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 adv ers e impacts or potential adverse impacts to the waters of the State other than from a disch arge? Page I of3 D Yes D Yes IE_ No DNA ONE ~N o DNA ONE 2/411011 Continued '!Facility Number: 1'"7 -{,72d !Date oflnspection: a:-G-/?.( 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! Structure 2 Structure 3 Structure 4 Identifier: 1<1 R;l_ "' ( Spillway?: Designed Freeboard (in): 19 l9" I ,.., Observed Freeboard (in): ~ 3~ aztL 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 IE.No DNA 0 NE 0 Yes 0 No D NA 0 NE Structure 5 Structure 6 0 Yes ~No DNA ONE 0 Yes fli..No DNA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public bealtb or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~No DNA ONE 0 Yes jB No 0 NA 0 NE 0 Yes ~ No D NA 0 NE 0 Yes 62j No 0 NA 0 NE 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes I.ZI No 0 NA 0 NE D Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus D Failure to In co rporate Manure/Sludge into Bar~ Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): h,uk Uzvg-4f....,ni/C&n I wA ~...:1-/.JPyk- j/l?dQ/1\ .Mdr;Vtall~ 13. Soil Type(s): 14. Do the receiving crops differ from those designated in theCA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check the appropriate box. 0WUP 0Checklists 0 Design 0 Maps 0 Lease Agreements 0 Yes [ll.No O Yes ~No DYes [2fNo DYes ~No O Yes 12:J-No 0 Yes ~No 0 Yes ~0 Oother: DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 NA D NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections 0 Sludge Survey 0 Yes !:3-No 22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~No 0 NA 0 NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? Page2of3 DYes ~No DNA ONE 2/4/2011 Continued . !Facility Number: 6-r:L -l,ziOj I Date of lnsl!ection: a--'--L!t. ' 24. Did the faci lity fail to calibrate waste application equipment as required by the permit? 0 Yes jE.No D NA O NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes (3J:..No DNA ONE the appropriate box(es) below. 0 Failure to complete annual sludge survey 0 Failure to develop a POA for sl ud ge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date offrrst survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? DYes ~No DNA O NE 27. Did the facility fail to secure a phosphorus Jo ss assessments (PLAT) certification? DYes IBJ No DNA ONE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 0 Yes ~No DNA ONE and report mortality rates that were higher than normal? 29. At the time of the inspection did the faci lity pose an odor or air quality concern? 0 Yes ~N o D NA ONE If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes ~No DNA ONE permit? (i.e., discharge, freeboard problem s, over-application) 31. Do subsurface tile drains exist at the facility? If yt:s , check the appropriate box below. [81 Yes 0 No DNA ONE ~ Application Field 0 Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 0 Yes ~N o DNA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE 34. Does the facility require a follow-up visit by the same agency? DYes 1£1 No QNA ONE Reviewer/Inspector Name: Phone: ?(~.:rJ()O Revi ewer/In spector Signature: Date: ~ ...... ~a?/¥~ Page3 of3 21412011 Type of Visit: Operation Review 0 Structure Evaluation Reason for Visit: ~outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Denied Access Date of Visit: If I )y 113 I Arrival Time: lq&'OA-H Farm Name: \V~ I I it.m S ftoj fm'~>J Departure Time:UO: \.rA!jl County: SP.rfti1 Region: f/20 Owner Email: OwnerName' 1\lt W!/11:: Mailing Address:l3 &, e 'kJ._ Ro~elxfo ~ ) Phone: Physical Address: ----------------------------------------------------------------------------------- • "·-"1/1 Facility Contact: )(,N) YYf r tfR £ Title: Mtno~ J Onsite Representative: __.t(""""""')~...._..-hJ---'i ..... l.:..h_.'a,J'"-'-"""---------------- Phone: Integrator: --~...H..~..--.......!..B"----------- Certified Operator: \( tn fv fl J f Om { Certification Number: -=\'-=~:.....4..:..;5:;.,..r_7 ____ _ Back-up Operator: R.ttv )'v{ /11't1mJ I Certification Number: ....;.J_q=j'-'5"->9 ........ _________ _ Location of Farm: Latitude: Longitude: Discharges and Stream Impacts I. Is any discharge observed from any part of the operation? DYes li} No DNA ONE Discharge originated at: D Structure D Application Field 0 Other: a. Was the conveyance man-made? DYes 0No DNA ONE b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No DNA ONE c. What is the estimated volume that reached waters 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 18J No DNA ONE ~No DNA ONE 214/2011 Continued .. jFadllty Number: <?;a--(p7J.-. !Date oflnspection: I J J4 J 13 Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure2 Structure 3 Structure 4 Identifier: Rt R~ l<J Spillway?: ~ll [~ Designed Freeboard (in): ~3 ~'5 Observed Freeboard (in): -1-..1-J,. (~) 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc .) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DNA ONE 0 Yes D No 0 NA 0 NE Structure5 Structure6 0 Yes !Sa' No 0 NA 0 NE DYes ~No DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify 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 improveme nt? Waste Application I 0 . Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? ~Yes DNo DNA ONE 0 Yes (R No 0 NA 0 NE 0 Yes IE No 0 NA 0 NE DYes I>JNo DNA ONE 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. DYes ~N o D 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 D Application Outside of Approved Area 14 . Do the receiv ing crops differ from th e 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 Jack 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. 0WUP Dchecklists 0 Design D Maps 0 Lease Agreements DYes 181 No DNA DYes lit No DNA DYes ~No DNA DYes '6$1No DNA DYes ~No DNA DYes CSJ:No DNA DYes ~No DNA 00ther: ONE ONE ONE ONE ONE ONE ONE 21 . Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE 0 Waste Appli cation 0 Weekly Freeboard D Waste Analys is D Soil Analysis D 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? 0 Yes 0 No ~NA 0 NE PDge 2 of3 21411011 Continued "' .· I Date of lnsJ!ection: lll ::J l13 I Facili!J:: Number: ~d-. -~7J..... 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes [)tNo DNA 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes 1)1 No DNA th e appropriate box(es) below. D Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels D Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? DYes ~No DNA 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes 0No ~NA Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes r)lNo DNA and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes f)aNo 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. ~Yes DNo DNA ~ Application Field 0 Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes r8No DNA 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA 34. Does the facility require a follow-up v isit by the same agency? DYes !R'No DNA Comments (refer to question#): Explain any YES answers and!Qt;•l,my additional recommend~9on~j o_r: any~otber commen Use drawings offacility to better explain situations (use additional pages as necessary). ,:~':1::.-'·~~~·-; •; .: ·-,;~ · . · ::".• ONE ONE ONE ONE ONE ONE ONE ONE ONE ONE ONE Reviewer/Inspector Name: Reviewer/Inspector Signature: Phone: 'f.lfC433-33{l){tf6ce) Date: Ntlv ll ;.;) 0 13 7 Page 3 of3 114/1011 .. Facility No. ~~4:>7~ Farm Name Wt\1 ~J fry ftr~YJ Date II IL/h) Permit ._/' COC ./ OIC_ NPDES(Rainb.J:.eake.r P.LAT Annua l Cert Daily Pipe) ~fll"-1 1.: ~~ b. ~ ~ 0'.:Qa~ F~ [ rops ~ . , .. Jl L Ctl IYJf\ _........ .... jj n.:JJ"J ~ q, ~ft1. . ., ..,I Lagoon Name, S for spillway 1 R I 210 Design Freeboard I Last Recorded (in) :J.VJ .1"'\ Observed freeboard ' Sludge Survey Date Sludge Depth (ft) ,~ i.:l.J' LiQuid Trt. Zone (ft) :1} j,~ Ratio Sludge to Treatment Volume if> 0.45 ,LIS d? Date out of compJiance/ POA? Calibration Date 1 YIRIJ:;) Ring Size (in) Design Flow (gpm) ~"' Actual Flow ICil~ Design Diam. (ft) ~ Actual Diam. ld-q· D Soil Test Date tOJrohl pH Fields 2 3 4 \..,./" Crop Yield -· Wettable Acres./ - I 31(, :'l'A 18 4-...J . "' 5 1.'3/itt/J}. .., 4 5 6 6 7 Transfer Sheets RAIN GAUGE 7 8 Lime Needed Lime Applied ~~ WUP =----Dead box or incinerator __ _ Cu-I __ .......Zn-1 ~ Needs S (S-1<25) "-"""" Needs P lin Waste Date -60 Day + 60 Day N (lb/1 000 Gal) pH Pull/Field Soil ~'-l-P3o ~(t) q,_rt4 lO Vl5",~"1 rvo 'Pr-~~ 'LW-Au P10 Mo l~l>-Pb Av ~~~-yJq "'(D <ti121J> Weekly Freeboard o../" 1 in Inspections __ 120 min lnsp .•. Weather Codes t.lidn. ~'"''' ~)Jl.Jn. , './ I ~J'i .IU'1 I L 13 J,;)'f l.lh J,IJ 1!.88 11'l0 / I ,/ / I('J J "' Crop Acres PAN lfjy,. ~i.<.,, ~ \.., , ........ 7 . ' liZ:Z_ l(nl'l'}v ~ 1 Ill~~) <b. r'l{S _,/ / Mortality Records Check Lists Storm Water l~illh IIIJJoqb .. .:u ,,D'f ln.tl i L3 } " Window Max Rate C-dh-c,tJo [tv, Se(\-H{ll D -AI'~-.<M IS t:Th'H(5G bUJ. )(){4~.1 7(). Har-s.:n. fr.1-~ c~~s " , ' .) 1 lr\,~<; ~4.1P~ If"' wS J J ./ MaxAmt Rb ~i tv-~Nf ,]1'11!1'1 .~1-)~~ ljQ ,~~~~O.)J fy PHO J::· rij BERS and affiliations 7 'I Q)r 11 o~ 'bl~ <i ~'( Date last WUP FRO ~1)10] FRO o r Farm Records \f( ~_r +--19 Date last WUP at fann Lagoon# ,)ISX)oq 3lo~(q'5" -r-3/ App. Hardware Top Dik e '5~) Stop Pump 4l) ~ .., r--Y.3 Start Pump I+ 7 solb JID Conversion -Cu -I 3000 = 108 lb/ac; Zn-1 3000= 213 lb/ac Date of Visit: llo(J ellA--I Arrival Time:l§~;-.f6tt Departure Tim~:llo::JD &11 County: SOrf5ch Region: Farm Name: \'! i \\\ ()h( fle7 R#qz Owner Name: .....JR~o~~~___,Jh,:....JU.;.ufi..Ll..klltVnr..;;a.-C -------- Mailing Address: Owner Email: Phone: Physical Address: ---------------------------------------:---- Phone: ;)'i~-;}O\~ {L) k ~ \A 1tlll\'*f N I Facility Contact: _:....:....:~~__;,'---=-v':....:....:...~::;~..:..;,..-~-----Title: ..-~U--wt)luP:!.l~lf-J,.J~Y:.__ ____ _ Onsite Representative:~ ~~'mL...&-.__.JtvL.o:--'i~l,.!...lul'tMo!L!..:\f-C __________ _ Integrator: _.!....}'1..!....-....:lB~--------- Certified Operator: k:{)?1 h-1 1 { l1'amJ Back·up Operator: Ra,t h-~ II r' am r 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 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: Certification Number: Longitude: DYes ISJ-No DYes DNo DYes DNo d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes DNo 2. Is there evidence of a past discharge from any part ofthe operation'? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Pagel of3 0 Yes &J-No DYes [8"No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 214/ZOJJ Continued '!FacilitY Number: ~ !h -lo]h !Date of Inspection: IOI!Ohh 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 Structure2 Structure 3 Structure 4 Identifier: kd~({Q:) .BI(Emil R~ UUcJII:e) ) I Spillway?: Designed Freeboard (in): IS l~ l~ Observed Freeboard (in): :?I ~9 3fj_ 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DNA ONE 0 Yes D No 0 NA D NE StructureS Structure 6 DYes ~No DNA ONE DYes ~No DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any 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. 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? DYes 1$1:-No DNA D NE D Yes 5f'No DNA 0 NE DYes ~No DNA ONE DYes ~No DNA ONE 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~No D NA D NE 0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area 12. Crop Type(s): Crul\. wheal= Mv-Coo;fo} 'f>frhlcdtL Hav; Srwollplb ()S 7 / /7 \_ /7 . 13. Soil Type(s): hlad"alk \5 7 Avt-ryvl//e D 14. Do the receiving crops differ from those designated in the CA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 23 . If selected, did the facility fail to in stall and maintain rainbreakers on irrigation e quipment? Page 2 of3 DYes DYes DYes Ei}No ~No 9No DNA ONE DNA ONE DNA ONE DYes (S;l-No DNA D NE DYes l$k-No DNA D NE DYes ~No DNA ONE DYes ISJ-No DNA ONE 00ther: DYes Ei}No D Yes D No ~NA 0 NE 214!201 1 Continued . .. !Facility Number: lj3~ -{alA. . I nate oflns2ection: lf21£0 lll 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes l»No DNA ONE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes ~0 DNA ONE the appropriate box( es) below. 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 to provide documentation of an actively certified operator in charge? DYes [S}No DNA ONE 27. Did the facility fail to secure a phosphorus Joss assessments (PLAT) certification? DYes 0No ~NA 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? E;J-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 DYes ISl-No DNA ONE permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ~es 0No DNA ONE S' Application Field D Lagoon/Storage Pond D Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~0 DNA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes DNA ONE 34. Does the facility require a follow-up visit by the same agency? DYes DNA ONE Reviewer/Inspector Name: Phone: q(/):l(J3-JJCC{cf6'cf) I Reviewer/Inspector Signature: Date: fJd: 10.~0/0l,. ;; Page3 of3 21412011 D i l .. ·· ~a--&7~ Facility No. <;l:;)ctylfO Farm Name ~ ~ [/ Ia,., C Date IOboJ I J Permit :coc Rb _.:__,. --ore_ NPDES{Rainbreaker PLAT Annual Cert Daily Pipe) FB reps 'i ; : I R}.. ldOJiiJ I ' .. : rnliJI/1 li~ fb.. ; ""'I ! ~~·· II ''- i ' rln IP._ -lll'lliT ' I;\ \I <bll-:;fh ! ! I l Lagoon Name, S for soillwav 1 I( 2R~ 31(/ 4 DesiQn Freeboard I Last Recorded (in Observed freeboard 'Jlj .1C/ 3J Sludoe Survev Date . /t){~-/11) Sludge Depth (ft) · . ' 8S:J ~~~'f 3-d7 LiQuid Trt. Zone (ft) l-f·'3 ),f1 4.~ Ratio Sludae to ;Treatment Volume if> 0.45 Date out of compliance/ POA? I I I ' I Calibration Date 1lff/SII~ 2 fltblrn 3 4 Rino Size (in) ! Design Flow (Qpm) b)W I:JI/\ Actual Flow. ' rat{8' ld-11 Design Diam. (ft) 1~5' :ltf Actual Diam. '3qD 1~0 ; I , r ~~~~ .-J. Soil Test Date 10. JUt .Y•wl11 pH Fields . I J0(}.... Lime Needed ol<J,;-~ ~IJr-{J Lime Applied i_....,....._ Cu-I / I Zn-17 I Needs S (S-1<25) AQ>v Needs P · Crop Yield fh-ty'--- Wettable Acres I~ WUP \,./'~-- Weekly Freeboard 1 in Inspections v- 120 min Insp. __ _ Weather Codes ( t;/J'f_ 5 Waste Date' ~IN I I.). lfJsin t-111~1" I b IJ:\IIl I 10/(~fr i 1~//d!J -60 Day I ! + 60 Dav I ! I N (lb/1 000 Gal) i 11 .01 .R) ll!h L )(} ll,q U( Q • .) l.ln :10 .7~ r~ [, ). pH ! l / / " .I / / I ! Rt't-kt1' Pull/Field ; ; Soil Crop Acres PAN Window ! IJo ~~(" tl i fv / l:11:_ .5P~ IQ, :r'"'_P>~. H Nu ll'a; : tk: I c;D I .tA 1.1 (' liN I ! I \IV Jh'-t ! I s _fJ ' I I I I . Verify PHONE NUMBERS and affiliations I I Date last WUP FRO I J FRO or Farm Records Date last WUP at farm 1 (7 OJ Lagoon # App. Hardw~re j Top Dike i i Stop Pump i ! Start Pump Conversion-.Cu-1 3000= 108lb/ac; Zn -1 3000 = 2 13 lb/ac I . kr I <II. 'Yl. 5 6 l I 6 7 Transfer Sheets RAIN GAUGE 7 8 Dead box or incinerator __ _ Mortal ity Records Check Lists Storm Water Max Rate MaxAmt ~ qh ~h ( / _f]Jo .7J. lq t;'S .T ~ I Operation Review 0 Structure E\·aluation 0 Technical Assistance Reason for Visit: 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: II Ob H 1 I Arrival Time: U 1 : 10 JHt I Departure Time: h ~ ~ JD fh I County: So,., ..,sa; Region: Fiy) l\ . '-4~ f·J5) I Farm Name: Mll!' lbti OOJ far"? Owner Email: -------------- Owner Name: R ¥ Jvfl11' tbtl Mailing Address: Physical Address: \~13 BoJJ Wfe ~ f?_o5e bora Phone: Facility Contact: ______________ Title: _________ _ Phone: Oosite Representative:~.;.....:..;~;....· .l...-_h;_:....i{!.JJ ..... l ..... Otn""'""a..5re...· ___________ _ Certified Operator: k' ~ bt{ I} t' tnff Back-up Operator: _R.....;.a~· (r-~'--'-{-'-!{/~i f2w.mr.r..:~~---------­ Location of Farm: Latitude: Discharges and Stream Impacts I . Is any discharge observed from any part of the operati on? Discharge originated at : 0 Structure 0 Application Field a. Was the co nv eyance man-made? 0 Other: b. Did the discharge reach waters of the State? (If yes, noti fy DWQ) c . What is the e stimated vo lume th at reac hed waters of the State (ga llons)? Integrator: --!.H...L...--_.6"""'----------- Certification Number: ~lz,_l/.......,'5_7......_ _____ _ Certification Number: ..... 1 ..... 9..::c3;..=5<1.....:.... _____ _ Longitude: DYes [)}No D NA ON E DYes QNo DNA O NE 0 Yes 0No DNA O NE d. Does the discharge bypass the waste management system? (If yes, notify DWQ) QYes QNo D NA O NE 2 . Is there evidence of a past di sc harge from any part of the operation? 3. Were th ere any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page 1 of3 QYes 0 Yes ~No D NA O NE [B'"N o DNA ONE 21412011 Continued !Facility Number: $d-. -h7;;).. I Date of Inspection: 10 h I 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 I Structure 2 Structure 3 Structure 4 Identifier: Kf l~nk) R1lfi<m) R;) IHrtHJeJ j Spillway?: Designed Freeboard (in): 1'1 1'1 l~· Observed Freeboard (in): 3~ ~:!. Jlf_ 5. Are there any immediate threats to the integrity of any ofthc 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 (X'No 0 NA 0 NE DYes 0No DNA ONE Structure 5 Structure 6 0 Yes ~ N o 0 NA 0 NE 0 Yes 5iNo 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 0No DNA ONE D Yes ~No 0 NA D NE DYes ~No DNA ONE DYes ~No DNA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~No 0 NA D NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 Jbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window D Evidence ofWind Drift 0 Applicatio n Outside of Approved Area 12. crop Type(s): Cor~ Mheai 1&,rbea,~; Coo.1al ~wlo flay; Swlt f"Q,b OvetJf&l 13. soit Type(s): NO"tolk Is ; &try\lme is 14. Do the receiving crops differ from those designated in theCA WMP? 0 Yes ~ No D NA 0 NE 15. Does the receiving crop and/or land application site need improvement? 0 Yes ~ No 0 NA D NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable 0 Yes l}i No 0 NA 0 NE acres determination? 17. Does the facility lack adequate acreage for land application? 0 Yes ~No DNA O N E I 8. Is there a lack of properly operating waste application equipment? 0 Yes ~No DNA ONE Reguired Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Pennit readily available? DYes 15(,1 No DNA ONE QYes ~No DNA ONE 20. Docs the facility fail to have all components of theCA WMP readily available? If yes , check the appropriate box. 0WUP 0Chccklists D Dcsi!,>n 0 Maps 0 Lease Agreements 00ther: _________ _ 21. Docs record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code DRain tall 0 Stocking 0 Crop Yield 0 120 Minute Inspections D Monthly and I" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 23. If selected. did the facility fail to install and maintain rain breakers on irrigation equipment? Page2of3 DYes ~No 0 Yes 0 No DNA ONE cg.NA D NE 21412011 Continued !Facility Number: ga. < I Date of Inspection: I{) h !11 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? lfyes, check the appropriate box(es) below. D Yes ~No D NA D NE D Yes 63 No D NA D NE D Failure to complete annual sludge survey D Failure to develop a POA for sludge levels D Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. [2J:Application Field D Lagoon/Storage Pond 0 Other: DYes fit No DNA D NE DYes 0 No IS'J NA D NE DYes fg No DNA D NE DYes ~No DNA ONE D Yes ~ No D NA D NE ~ Yes 0 No D NA D NE ---------------------- 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? D Yes ~ No D NA D NE D Yes j29 No D NA D NE 0 Yes ~ No D NA D NE Comments (ref~r::!91gu¢~$i~ijt#t)~~Explain any YES answersiandlor ~ijY.tatiilit!~i!~lli~~:ommendations or anyotber ~~)ilin Use drawings otfa~~((j;j,](t'e~~explain situations (use additional~8.~,&\if:{t~ljtcy); ·. · . ' · · . :, : :6/:.c ,~~ "'-'.,. ~·:~ • • • '. ' I 7, P~e.. vvortlt en bcre..sftrU en fD,.·lJ)+ la_J~Ch. Add. *'fsof I 5fftl/ q m .. Ad. 1-?-t".) *'~'ir)r !MJ. IJhle ~~~~~~~-• 01-1\f/ ~ loJ~J hu.e_ r:e~ JoaJ LO•r ' )5'~ SuffotH~ f~-tilii..fr f .. J/-01) .so-ne -neldJ ih 1)1''' /. so,bt:lhJ h~Mcrded~t-.. 1~ P.r~e.-f~ ?" tY-t e dmfh -+-;I e. on fvliJ ~)-30; v·ft( n.:vey f'·/Mfed -dtorJ ,J~rfo,l~t'fd''*~ 9f.>ty -4-/J.,t}d_ s~ (V) e6t srd-r. Reviewer/Inspector Name: Reviewer/Inspector Signature: ~-Page3of3 Phone: CfJ()-lf3J-3J?J? /rffi' Date: Dei-7, ;:)O I J T • 11411011 Facility No. COa7l. Farm Name WI ltth1f ~ ~ Date _____ _ Permit '--/ COG __., OIC m Q. ~ NPDES (Rainbreaker ·Bt PLAT Annual Cert) $' ~K1 Pop. Design Current FB L"" h 1._ Type Drops 11ln 10 ro<~ ru P-\2-~or ~bDilct 0. L.o. l1lL cr I II)/ II 1ll l.rt'l fl't Ql7 rq I~ ~I ., 01''11C I ~til 1 ) Lagoon J)l 1 ~)Q ku3 S~Uway I Design freeboard Observed freeboard (in) .-3'1 ·) '--j .-.,:l. Sludge Survey Date l(,.,b'-1111 'lhiJ.'If& lh/J1S' llr Sludge Depth (ft) Lig_uid Trt. Zone (ft Ratio Sludge to Treatment Volume Calibration Date 1 ~llblfD 2 Design Flow 'd'iY_ Actual Flow l<l'tr Design Width ~J Actual Width 1~'60 Soil Test Data/:lhf/J/ pH Fields Lime Needed fv'O Lime Applied ~ Cu-I Needs P Cro Yield Pull/Field I~JII-P-1o \}-II-~.:n PI-P) PJA-Ps'A ~ P>--P.ffi ~ ?1.. 0'4 P-lo JJo llo AIJ Av Av ~ .. AID IWo Soil Crop "trn h,~St1t frm' J.;~ 9t J CJHLSC,1 / ~JJft_sro ~"".Jv~S c!hls c ~s !"hi'S J .J' l'3,'t Jr:1 1~(0 llt.C, 11.1._3 l7r/ 3 4 Wettable Acres c...- WUP ._/--- Weekly Freeboard __ 1 in Inspections __ 120 min Insp. __ _ Weather Codes Transfer Sheets Acres PAN CJ)I-r&Jl,. IJII. -n'QJ. m ..) J / / ilfi._\(.o ~+-ttr Jfnq 'i"D '" J ~.~J1J.~-o . .J' / ·~ .. ~ o-"7l t'vlllb1 c«rf Venfy PHONE NUMBERS and affiliations SO'fVI!ffJtOS Date last WUP FROJ.II')fbJ Date last WUP at farm FRO or Farm Records Lagoon# Top Dike. Stop Pump Start Pump a~lcry Conversion-Cu-I 3000= 108 lb/ac; Zn-1 3 000= 213 lb/ac 5 JZ;)..._ l<t. Y/lt-111 0 "'7}!}/LL !t1 ~ ' ~ '11:ro IIJ 4 5 6 7 6 7 8 RAIN GAUGE Dead box or incinerator __ _ Mortality Records Window Max Rate Max Amt ,9p '.J I ~--~ 114--Sf;y A?f-.!kft I~ Ap'p . H'ardware Type of Visit @"Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ~outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access Date of Visit: I \.d Ji1 Jc 0 I Arrival Time: I IIJ: '-fo kjf Departure Time: ll:roo P7l County: SatrJfith Region: Fll(J Farm Name: W!ll!1 fl.ns tWa taun Owner Email: ----------- Owner Name: ~o..r \'vi f I,, 11M r Phone: Mailing Address: ---------------------------------------- Physical Address:-----------------------------"------------ Facility Contact: Phone No: d 49-J~ ~0 { c.J / ---lku..\.:.u.tYl...,.._...L)v~f IL-.!.l....:..tm~J-r ___ Title: ..~-M..u.rn~~~AL-r ____ _ Onsite Representative: ....:..k~~"'-+-__,_&...._./ '-'fi_.I_..Oa1atL..J:Lf_________ Integrator: .... H_._-_,B"------------ Certified Operator:__;,~~:/.,___ _____ -~.:......ol ...... l_,_\\,.,~~f..__ ____ _ Back-up Operator: ....JKu,....:lVn..!...f'------......:..h-.;..;~:..~.I.J..\\~a.llltt:lt.~.U~----Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts I. Is any discharge observed from any part of the operation? DYes ~No DNA ONE Discharge originated at: 0 Structure 0 Application Field D Other a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters ofthe State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Page 1 of 3 DYes 0No DNA ONE DYes 0No DNA ONE I DYes 0No DNA ONE DYes !SlNo DNA ONE DYes ~No DNA ONE 12118104 Continued [Facility Number:~~-(!D._ I Date of Inspection lla.b\J II e I Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes , is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: '<1 l&clt l ~rlFTDrl-) JQ.{ HIJJ~l I } Spillway?: Designed Freeboard (in): ]9 lg ~~ Observed Freeboard (in): 2>2 a~ :3~ I 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 ~No DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 DYes f5dNo DNA ONE DYes 181No 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 IO. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes f5a"No DNA ONE DYes ~No DNA ONE DYes I:R-No DNA ONE DYes ~No DNA ONE 11. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes r5!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 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. cmp type('l Co~io.~ Px:t .. ~ S~m II gmib /lVtvfr£: Corn, 1>®1; So1lerhl 13. Soil type(s) M_\IJlf _!-~~JJr · J 14. Do the receiving crops differ from those designated in the CAWMP? 0 Yes fikNo DNA 0 NE 15. Does the receiving crop and/or land application site need improvement? D Yes ~No DNA 0 NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?D Yes fia No 0 NA 0 NE 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reviewer/Inspector Name Reviewer/Inspector Signature: Pagel of 3 DYes l'JNo DNA ONE DYes ~o DNA ONE ... I Facility Number:~ d.,. -~]:) I < Date oflnspection lla {'j\, rp I Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other DYes ~o DNA ONE 0 Yes ISCNo DNA ONE 21. Does record keeping need improvement? Ifyes, check the appropriate box below. DYes l)a No DNA D NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Annual Certification D Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections D Monthly and I" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? 23. If selected. did the facility fail to install and maintain rain breakers on irrigation equipment? 24. Did the facility fail to calibrate waste application equipment as required by the pennit? 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? Pagel of 3 DYes rH"No DNA ONE DYes DNo ~NA ONE DYes fia'No DNA ONE DYes 15lNo DNA ONE DYes 'E!No DNA ONE DYes DNo ~A ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes 8No DNA ONE DYes tg'No DNA ONE DYes ~No DNA ONE DYes r8'No DNA ONE 12/28104 ... Date ____ _ Facility No .~7J.... Farm Name ~/IHo,r ~·fi:rlh Permit COC ""/ OIC / NPDES{Rainbreaker PLAT l(~f Annual Cert ) Pop. Design Current FB ~~~l%111 I I Type Drops 70_ ~I iJ/r /(}(( U~5flD_ II~-;. I«>G ~,.., .-ltd.... -""" L..I.L I'Mr"1rJ' 8-11~110 ill dto I';;,'IK 1 1l ~~~~6 \)I~~ It b Lagoon lk:l1 IRJ 2 1~3 4 5 6 7 Spillway " Design freeboard Observed freeboard (in) ::n ~ ~ ~1> ... P-.. Sludge Survey Date l/fil\11 () r7' ., Sludge Depth (ft) :;, 4. ;),(a ;),~ LiQuid Trt. Zone (ft ).5 ;'ir ~ -;,4 Ratio Sludge to Treatment Volume ,~3 ,')() ~;)') Calibration Date 1<;?//t.,{{() 2 3 4 5 6 7 8 Design Flow :>~ -Actual Flow ~4.-\- Desicm Width «'6) .. Actual Width d.~f) Soil Test Date 4/tr-ff 0 Wettable Acres ~ RAIN GAUGE pH Fields ' WUP Lime Needed fl/o Weekly Freeboard __ Dead box or incinerator __ _ Mortality Records Lime Applied 1 in Inspections __ Needs P--tJ6>' fJJ s I Weather Cod.es · .. r ~ ~.a .... L ~ ~ 1 .h.-I h, ~A Cu-I ....-Zn I --:1( 120 min lnsp Crop Yield \/ ~ d~. Transfer Sheets fu ~--f-rchm1 1V5 r~~ rvO V"'f'tff ((U'';J + 60 Day Ill 1(1 t. PuJUField Soil Crop Acres PAN Com/Wh 1\JI /I'd) ~~-~(4 ' 1'1Jtt(f~ i~ltrA s{)y Jwr. 7 Venfy PHONE NUMBERS and affiliations Date last WUP FRO Q-ll-o.J Date last WUP at farm FRO or Farm Records Lagoon# Top Dike 'Sv /) Stop Pump )Olb StartPump ~ Conversion-Cu-I 3000= 108 lbhl~ Zn-1 3000= 213 lb/ac l\~)~ ~~~ l.\5 Window Max Rate MaxAmt 11 I \ / Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for. Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access Date of Visit: I!!Tc:::/d21 Arrival Time: Departure Time: l//.'"0 1M [ County: 5~,¥n ~4 ~~~~~~ ~ Region: F7z.6 , Farm Name: Owner Email:---------------------------- Phone: Mailing Address: ------------------------------------------------------------ Physical Address: .........:1'-7.:......;;.3.....:1'~___;;;/3::....~=~--'?eJe=....c:s;-.~=-Ef--=-· ____ _.k~~==:...=..------ Facility Contact: ---.:..J4~Wl--=---W-t~/..:..:/I:..;.~:..:..:....:;:.;;;S;....__Title: ---------PhoneNo: ______________ __ Onsite Representative: ----"'/4=-;..*'...:....---J,J.='-'I'-'I ... J.'"",-"""'--"-=:;;,,5=-------Integrator: ------------------------------ Certified Operator: ___ /?.L..J~/?io::~y!:;;J~-------_ ___.W.~"""/ ..... 1.;../...,Ia..,.'..:.~:..===-------Operator Certification Number: Back-up Operator: -----------------------------Back-up Certification N umber: Location of Farm: Latitude: D OD 'D" Longitude: Disch a rge s & Stream Impacts 1. Is any d ischarge observed from any part of the ope ra ti on? D Yes ~o DNA ONE Discharge originated at: D Stru cture 0 Application Fi e ld 0 O ther a. Wa s the conve y ance man-ma de? b. Did th e di scharge reac h waters of the State? (If yes , notify DW Q) c . Wh at is th e es tim ate d vo lume tha t reached waters of the State (gallons)? d. Does disc harge bypass t he waste manage ment system ? (If yes, notify DW Q ) 2. Is there evidence of a past di sc harg e fro m any part of th e opera tio n? 3. Were there any a dve rse im pacts or potenti a l adv ers e imp acts to th e Waters of the State othe r tha n from a disc harge? DYes 0No ~A ONE DYes 0No ~ ONE I D Yes 0No ~ O NE DYes 0'No D NA ONE DYes ~ DNA ONE I Z/18104 Continued I Facility Number: (?;l-t:f??Jz Date of Inspection 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 2 Structure 3 Structure 4 DYes ~DNA ONE DYes DNo ~A ONE Structure 5 Structure 6 jjructure I Identifier: / lwpm Spillway?: A~~ ~~~~---------- Designed Freeboard (in): --=-1_.1..._ __ ---J?&.....,.oi<-------..LI~::Z::6--------------------- Observed Freeboard (in): ,3D ~ ~ ______ ------------ 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 ~ DNA ONE D Yes lid1i'o 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 DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ~o DNA ONE DYes ~ DNA ONE DYes lB'No DNA D NE DYes DNA ONE 11. Is there evidence of incorrect application? If yes , check the appropriate box below. DYes DNA ONE D Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area 12. Crop type(s) --=d:..::....!~:::..!:::.!..:kJ::::z.....__:::~::::::~~~· .l....{/.L:!!~'::S4:1-,)1-j+S(~~~05!::::::::::::::~;)~G1w~~r+-;;-...!:!:I-.J~~~,J~,,.....--;..j~DY,p::.hw,s~~ 13. Soil type(s) Nar£1/L) tiJry tJ/UL 14. Do the receiving crops differ from those designated in theCA WMP? 15. Does the receiving crop and/or land application site need improvement? DYes 0No DNA ONE DYes DNo DNA ONE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? 0 Yes D No 0 NA 0 NE 17. Does the facility lack adequate acreage for land application'? 18. Is there a lack of properly operating waste application equipment? Reviewer /Inspector Reviewer/Inspector-···--·,_... DYes 0No DNA ONE DYes DNo DNA ONE I Facility Number: :g! -Ot>"~j;:L. Date of Jospe<doo ~ 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 appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other DYes ~ DNA ONE DYes ~o DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes ~o 0 NA D NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers 0 Annual Certification D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes (g1fo DNA ONE .23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes 0No ~ ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes lia'No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~0 DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes ~0 DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes DNo ffNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~ DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes IIHfo DNA ONE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~0 DNA ONE If yes, contact a regional Air Quality representative immediately 3l. Did the facility fail to notify the regional office of emergency situations as required by DYes le'No DNA ONE General Permit? (ie/ discharge, freeboard problems, over application) ~0 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes DNA ONE 33. Does facility require a follow-up visit by same agency? DYes ~0 DNA ONE o...re.. a._ ~ ~ ~~£. u.JW'~t.IJ trr-~~~ ~.5.) o~~t\ 12/28104 Type of Visit fl5 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit -''9·Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: If d D log I Arrival Time: R :10 At'\ I Departure Time: Ito: :>J:../11 County: S411psth Farm Name: 'tvfl lllhrs H~ R¥"? Owner Email: -------------- 'C\ "'.lr II ,, ~j Owner Name: _n.L.l..Joa&.:y..,_ __________ ,__._ .,._ .:....:..J.u.~a....:..o""'-------Phone: Mailing Address: ---------------------------------------- Physical Address: O!lf Sa.sr lalr-e fd. Facility Contact: K ,hJ \v~ II t Q,., ~ Title: -----------Phone No:--------- Onsitc Representative: ------------------ Certified Operator: _R~'+r-----.....a.:~...!.l..a...l&-&h'...aa.,q.,..J..r ____ _ Integrator:---------------- Operator Certification Number: AhA JCf3S' Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: D OD'D" .. .· ·.·Design Current Design Current Design '~~~~rfrit::;:: Swine ...•... -:;.~·Capacity Population ~~fPoultry Capacity Population Cattle Capaciti:~'if:gi¥1)iti~~·-~~,: f.[]~w..:.:...:::e.:::an:.:....:.:to:....:F:....:i.;;.m:.::.·sh::_f----~-------1 ~0:::;-:L:::.;ac;.;.y...:e.;..r ---+----t------iii:D::-:D~a::.:.i:..~.....IYC.:::.::..ow::.:....__+---+-------1::: ·~[]~w~e=an:.:....:.:to:....:F:....:e~e.:::de~r-+~~-~~--~ ~D~N...:o.:::n::.;-~L~ay~e~r-L----~----~-~[]~D~a::.:~:..~.....C~al~f-~r-----t---~~ l6a' Feeder to Finish 530"> 5340 ·· · [] Dail)' Heifer [] Farrow to Wean ~[]~D;:;)ry~Ct:....o~w.:::.!!.::.!......---1r----t---~ ;;: Dry Poultry [] Farrow to Feeder []Non-Dairy ·[]Farrow to Finish 0 Layers []Beef Stocker [] Gilts t;:[]~N_o_n_-_L_ay'-'ce""'rs;;..._+------lf-------t !;;[]~B::.:e:::.::e~f.::::F.:.::ee:::.d.::.:er:.:.....---f----+----i ~,; · [] Boars · [] Pullets [] Beef Brood Cow h 0 Turkeys ~..:::::.:::.:::.:..;~~..::.::::..::.a.._--:-_.J...-__ ~ ". ~~th~cr . I B ~u;:ey Poolts ~]~er of S~ctu~~S'~jl~ Discharges & Stream Impacts I. Is any discharge observed from any part ofthe operation? Discharge originated at: D Structure D Application Field 0 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 I of 3 DYes ~No DNA ONE DYes []No DNA ONE DYes []No DNA ONE DYes []No DNA ONE DYes !SiNo DNA []NE DYes ['&No DNA ONE 11128104 Continued jFacilitY Number:<g ;t -~ Date oflnspection IIJjn @ 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 l Structure 2 Structure 3 Structure 4 Identifier: l: & de ~-H rJJf.e 3-fforl: Spillway?: 0 Yes 18J-.Io 0 NA 0 NE DYes 0No DNA ONE Structure 5 Structure 6 Designed Free board (in): ..........:.Jq-L-----___._l....l<j _____ .-..1 j-'--~-------------------- Observed Freeboard (in): ~d'j ;)'j .J:t!t ~) 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) DYes ~No DNA ONE 6. Are there structures on-site which are not properly addressed and/or managed DYes ~o DNA ONE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental tbreat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8 . Do any of the stuctures lack adequate markers as required by the permit? (Not a pplicable 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? RYes 0No DNA ONE 0 Yes IS'No DNA 0 NE DYes [2No DNA ONE DYes ~No DNA ONE 11. Is there evidence of incorrect application? If yes, check the appropriate box below. D Yes f)l No 0 NA 0 NE D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN > 10% or I 0 lbs 0 Total Phosphorus 0 Failure to In corporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12. Crop type(s) CA&J-giJHtJ!! vJIL ill-ayl' ~6 a<; (b'!, },t~twt s,Jen { 13 . Soil type(s) W(}folk ls ' Mryvllle lr J 14. Do the receiving crops differ from those designated in the CA WM P? 15 . Does the receiving crop ancilor land application site need improvement? 0 Yes l)aNo DYes f)dNo 16. Did the facility fail to secure and/or operate perth~ irrigation design or wettable acre determination?O Yes Cif No 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/) nspector Signature: Page 1 of 3 DYes ~N o 0 Yes !K'No 11118104 DNA DNA DNA DNA DNA ONE ONE ONE ONE ONE I Facitity Number:~~ itOJ....I Date of Inspection II Hh IDS Reguired 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. D WUP 0 Checklists D Design 0 Maps D Other DYes i)tNo DNA ONE DYes ~No DNA ONE 21. Does record keeping need improvement? lfyes, check the appropriate box below. DYes l)t'No 0 NA D NE 0 Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers D Annual Certification D Rainfall 0 Stocking D 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? DYes ~No DNA ONE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes DNo ~NA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes f¥No DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes ~No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 0No (SNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes 11tNo DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes llhJo DNA ONE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? DYes O(rNo DNA ONE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by DYes General Permit? (ie/ discharge, freeboard problems, over application) ~No DNA ONE 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE 33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE Page3 of 3 12118104 Fa9il~ No. !.}jt?J. Farm Name lv 1 I I f"n£ ttr, FJp, Date uln lor ~e rmit /Coc / OIC NPDES (Rainbre aker PLAT Annual Cert ) - Pop. Type Design Current FB Drops I I I I l J Ill La goon 1 4 5 6 7 Spillway Design freeboard ~ Observed freeboard in ~y ~ 'i _:)Q ~ rS=I=ud=fg='e~S=u~N=ey~Da=te~--~P=er~m~L~iq=IU~id~{~1ft)~-4~j,~f!Y~~~~~~~'~~~~··ri~~-+----~----1-----+---~~~b~ ~------------~S~Iu~dg=te~D~e=p1t~h=ft~>l~~~~!q+-~I J~.q~o~~l~~·~';~~o ~--~----~----~--~~~~/ Calibration Date 1jJ IS/0/t, 2 3 4 Design Flow ll'l' . Actual Flow on De sign Width Actual Width Sit~ ;.m.....,~v\~ ~ Soil Test Date "'-~t.e' ~:ca?t"U. pH Fields '.Y""""" rbp eld / Lime Needed \ \qfDt Wettable Acres 7 Lime Applied . ~l.. WUP ..L Cu zn ~.ct\\,sk... W~e k ly Freeboard --6- Needs p---1 ~ ~l\i.+ Rainfall >1" Pull/Field Soil Crop Q,." No I ~nAn--(!Jrar, ~ 1-it.CM/ol ~~ A~~ 1Sf,_,l1t / a ' r~" Au .~ fl-Ph IM,..,~I~ ,_. t~.....-\l~-lo ''~' IPJ-Ji> I~ fir ( I , 5 RYE 6 7 1 in Inspections 12 0 min Inspections W e ather Codes Transfer Sheets RAIN GAUGE 8 PAN Window Ill ~\7wt.D l'h S'Pti1 -~d. 'Jt.tt ,., tJrJ. .. Sllf. ~D 'Oc.i-~~ 1>.'1 Ftf,lr-~ l1:l Se,f-11tCJt ' .30 Uv.D c~~·'· 1-'ln M-~~ q_)\ ~ , , / 1.111 I'M,""'} \-\W. JT'/ J .. fVt ~ Venfy PHONE NUMBERS and affili ations S,~J ~~ D a te last WUP FR~)OJ Date last WUP at farm Q App. Hardware 1U_ ? :1;\ .. ~ : Wof"A~ Ma x Rate in/hr Max Amt in . Top Dike S;).~ 4 ~·/ Stop Pump 141-T ~~~} {"} Start P u mp 5o.t 41. ~ ~(f-f'~ ~Sf ~.~ Wo Av y'IJ18iiv,A:_-1tt{lclQ?) \1'1\rf&-rleco J.; O.f/p -o,s-~cr 0.7;)_ 0 -~ 31 (bib \ 4 2> If Ha ·,) J:~n {<\..~ ' 'r' Type of Visit -e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit -$-Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access DateofVisit: I rz1n[d11 Arriva1Ti~e:l4. ()C OOJ DepartureTime: 1/o/) I County:~~~ Farm Name: w·,\\\OJ-4\~ \--\cs,_ts \=a_W'(Y\ Owner Email:----------- Region: Owner Name: 'K~ \.(): \\~Qh'\~ 'S Phone: Mailing Address: ----------------------------------------- Physical Address:-.---------------------------------------- _,\Z'-=-\_,m:...:...:..,.....;\,N;,::..,.;..... \"-"\-=-~...:..::~=~...:...=,___ __ Title: ____;~:::.....o~:.-'.....lDo..t...:::W=.o...L;Qf=------Phone No: ---.-----,----Facility Contact: On site Representative: _K..a.....::::.:.·~...l;M-=-"-........:.~-= ....... :....· \~\..>......,;i Q""'"'-Y't'\-.::>-=-------Integrator: pf em S+d L rn -6) Certified Operator: _R.:......::~f..'J.l.J.l.c:::::=+c:-----_W...._=..~)_,\...,\ .... ·:-=<k=---Vb........,,S,._____ Operator Certification Number: \'j 3~ CJ Back-up Operator: \(:~ W..: \ \tC\M~ Back-up Certification Number: I~ 4-S'] Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts I. Is any discharge observed from any part of the operation? Discharge originated at: D Structure 0 Application Field 0 Other a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notifY DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notifY DWQ) 2. Is there evidence of a past discharge from any part ofthe operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Page 1 of3 DYes ~No DNA ONE DYes 0 No )"JNA ONE DYes DNo ~A ONE [ I DYes 0No ~NA ONE DYes ~No DNA ONE DYes DNo ~NA ONE 12/28/04 Continued I Facility Number:~)..-(£1d-l Date of Inspection ~ W~tste 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: Rl QL K-/ Spillway?: Designed Freeboard (in): (q 19 ICJ Observed Freeboard (in): al, .~ l ~ Q '31 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe ero sion, seepage, etc.) 6 . Are there structures on-site which are not properly addressed a nd/or managed through a waste management or closure plan? DYes ~No DNA ONE 0 Yes I)JNo 0 NA 0 NE Structure { Structure 6 0 Yes 'ii(No 0 NA 0 NE DYes ~No DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7 . Do any of the structure s need maintenance or improvement? DYes ~No DNA ONE 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) 0 Yes ~No 0 NA 0 NE 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? DYes ~No DNA ONE Waste Application I 0. Are th ere any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes Qt)No DNA ONE II. Is there evidence of incorrect application? If yes, c h eck the appropriate box below . 0 Yes ~N o 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload tJ Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 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 Area 12 . Crop type(s) &am 44 J Sm C,, 0/5) C -W-~ 13. Soil type(s) f\)~r to ( k_ ) A lA ~~"'j v ,·I U 14 . Do the receiving crops differ from those designated m the CAWMP? 15. Does the r eceiving crop and/or land application site need improvement? 0 Yes !!No DYes ~No 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?O Yes ']Sl'No DNA DNA DNA ONE ONE ONE 17. Does the faci lity lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? DYes ~o DNA ONE 0 Yes [jl No DNA D NE Comments (refer to question #): Explain any YES answers and/or any recommendations or any otber comments. Use drawings of facility to better uplain situations. (use additional pages as necessary): Reviewer/Inspector Name Reviewer/Ins pector S ignature: Phone : Date: Continued Date oflnspection I 11"j fi ,,j I Facil.ity J(Jumber: <td.. -{o 1)d ,. Reguired Records & Documents 19. Did the facility fai I to have Certificate of Coverage & Permit readily avai \able? 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 ~No DNA ONE DYes ~No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No DNA D NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections D Monthly and I" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Did the facility fail to conduct a sludge survey as required by the permit? 26. Did the facility fail to have an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? Otber 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: DYes ~No DNA ONE DYes 0No ~NA ONE DYes (;&lN'o DNA ONE DYes lilNo DNA ONE DYes l;ijNo DNA ONE DYes 0No -5NA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes a{ No DNA ONE DYes ~No DNA ONE DYes ~0 DNA ONE DYes 2g'No DNA ONE ... - -..... 12/28104 Facllity No. ~).-\> "1 :>--Time In cy Qi:) F;rm Name W :\~G,w;;. ~'-~ Time Out____ Date Integrator Jv\ -b . <._.,..._:) (S Owner -~---:-----'ld------------Site Rep-----:=:---------- Operator : \CcWJ No. \ C\ 'S 5<J Back -up ---->....:::~=::',;.::::\):..........:...Q_:.._.---='->-.J-=·=-· \~~"--:"'-~oc-----No. 1 1'-f <;I ----: COC ___ Circle: enera or NPDES Design Current Wean-Feed I AI, .-: . .,-,r-............. <&_ed -F Jni.sb-.1 5~0~ )~(J..J Farrow-Wean FREEBOA RD : Design I Sludge Survey D U E"' CropYield ~ -Rain_GaugP __ ~ __ Soil Test ....:;~~---Wettable Acres--~-- Weekly Freeboard ~ Daily Rainfall ~ Des ign Current Farrow-Feed Farrow Finish Gilts I Boars Others rl.t ~l Observedl~ /3~.., _/ 'St Cal ibration/GPM _<:::.Jv._---'1'---_.J_~_ Waste Transfers _.____. __ _ Rain Breaker - PLAT ____ _ 1-in Inspections .....---- Spray/Freeboard Drop ---------------------- Weather Codes__ 120 min Inspections __ _ Waste Analysis: t_ l \(t ~=+=---~N~itr~o~ge_n_(N_}_ [.Vb ·J .• ~ (,{_ lo/c~ /. ~ {, ~ 9/r'J 1·3 1.7_ Date Nitrogen (N) ~7~3 {.;f f ·~ _1_2.~( ~2''+/~o~Co'--__..1_· _'2_:::._.:..._1· L/ Pull/Field Soil Crop Pan Window 1 I .( / i ./'\. V\.. ~{L \.._· I t ( / "J-/11-~ I 1 LAJ I"<:"" J -~ v " Cft. 1'\ fl ,.... ..- H lD l))A... Jo-.J-1 c2_(p'l Yf\~v-W c .... (-,r • ~(I") 0 c .f -fl-..~.,,., Q /""' ""' l I l___ ()"i /. w ~<-/Cf 7 ..... )J.,-~"'L s /')-Qf'f-1/1<( 0 Technical Assistance Type of Visit 4i Compliance Inspection 0 Operation Review 0 Structure Evaluation Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access Region:'£ Q...O Mailing Address: -----------------------------------____ _ Physical Addrel>s: --r-7·-:------:---:---------------------------:=----,r--.-=---- Facility !.!.f.":~: K; Yt1 lA.) : Jl \ 0-nl .S T;tlc: ~ lil -Q UIXl(jl" Phone No: 5leiJ lJCJ7 (J Onsite Representative: ~(Y\_ \ih \\.i C\. V)\S Integrator:? t e!n ~ J_ Certified Operator:.¥( ~-m. l0 ~ \ llo..m.s Operator Certification Number: I Bt£ s1 Back-up Operator: ~ l.AJ~ \ LAO.his Back-up Certification Number: 19 35 'J Location of Farm: Latitude:. D 0 D' D" Longitude: D 0 D' D" Discharges & Stream Impacts I. Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Application Field 0 Other a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notifY DWQ) c. What is the estimated volume that reached waters of the State (gallons )? 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 I of3 DYes ~0 DNA ONE DYes 0No ~A ONE DYes 0No~A ONE ---I DYes 0No .fia)NA ONE Ove, _to DNA ONE 0 Yes No DNA ONE 12128104 Continued IFacili~ Number: <6:2 -{p 1.) I .. . Date of Inspection ~ ~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? ~cture 1 ~ructure 2 Structure 3 Structure 4 Identifier: I \ ~ l<l Spillway?: Designed Freeboard (in): (q ft l~ Observed Freeboard (in): d.5 :;(9 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 ~No DNA ONE DYes 0No ~A ONE Structure 5 Structure 6 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 DWQ 7. Do any of the structures need maintenance or improvement? -Yes ~ NA 0 NE 8. Do any of the stuctures lack adequate markers as required by the permit? D Yes PalNo D NA O NE (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ~o DNA ONE DYes DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~0 l&No DNA ONE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12. Croptype(s) '&..vmLA.J().. ~ 1 ~ Gt c:>(s 13. Soiltype(s) Nov~o\k , 8\l-\-f'(S ~ \k 14. Do the receiving crops differ from those designated in theCA WMP? ~rn-'WRoa.~ -~5 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 acre determination? DYes ~No DNA ONE DYes ~o ON~ ONE DYes')& No 0 NA 0 NE 0 Yes 'EPNo DNA D NE DYes ~No DNA ONE 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reviewer/Inspector Name ~.d:~~:;;LLl~~:...,_-?~~p;.:.nu:;,j;lX::!,L;;_ ______ _! Phone: Reviewer/Inspector Signature: Date: Page 2 of3 I F~ilicy ~umber:Ol -(,') jJ Date of Inspection ~ Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box . 0 WUP 0 Checklists D Design 0 Maps 0 Other DYes ~o DNA ONE DYes ~No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No DNA 0 NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and l" Rain Inspections D Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes ~o 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~No 24. Did the facility fail to calibrate waste application equipment as required by the permit? D Yes ~o 25. Did the facility fail to cond uct a sludge survey as required by the permit? 0 Yes j2{.J'lo 26. Did the facility fail to have an active ly certified operator in charge?. D Yes B"No 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? 0 Yes ~No 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 ~o DYes §No DYes )g:No 0Yes~o DYes ~o DYes ~-0 DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE Additional Comments and/or Dr!l~ngs: : :·.~:;>~:, '. . . :.~·:~r~·~~~;~~~i. .. ~-\~. .. : '." ·,: ..... - ExcE11£NT ~,qe;u._ I ) Keep IA..f --~~ ~cocl LA.DA.1: I ' -.... Page 3 of3 12/28/04 .Division ofWater Quality 0 Dil·ision of Soil and Water Conservation . 0 Other Agency . . ·· · Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit • Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access DatcofVisit: l.!l-IO·Q(...-j Arriva1Time:li':60gl&1.. I Departure Time: 1.__ ___ .... 1 County: :$i:c-..psh-Region: Farm Name: w.·lL i~~t."""-'11 t~n·J EAYIM. Owner Email: ------------- Owner Name: &,.,~ ~ ki ""'-k.Jill•'tJt.lk~---------Phone: MailingAddress: /~t1 B~t.s-S ~he g,{ R,J'I! ~or--e. M~C~.Ii!!rf2...:1~5w.f!....:l.~------___ _ Physical Address:------------------------------------____ _ Facility Contact: l«.r. l.u: ll;"'-._r. Title: -----------PhoneNo: ________ _ Onsite Representati,•e: tMa.it &.,e Ro± Integrator:& . .,......·~ Certified Operator: &,'t lu; U ;"-b s Operator Certification Number: I~L-~~S"=--j,~_ __ _ Back-up Operator: Ki ..._ l(-£.u; ll;tU-.::::$ _________ _ Back-up Certification Number: I ~¥'~1 Location of Farm: Latitude: D OD'D" Longitude: D OD'D" Design Current Design Current Design Current Swine Capacity Population Wet Poultry C~pacity Population Cattle Capacity · Population 10 Layer D Wean to Finish D Wean to Feeder s.rc,¥ ~ Feede r to Finish nos' .... ~· oz II ! D Farrow to Wean I 0 Farrow to Feeder I I D Farrow to Finish I 0Gilts D Boars --·· .. ·----_. ,!J Non·Layet I I It 0 Dairy Cow I I D Dairy Calf ' 0 Dairy Heife1 0DryCow : I D Non-Dairy I I D Beef Stockel I D Beef Feeder I I D Beef Brood Cow I --.. -. --~ --- Dry Poultry D Layers ~ D Non-Layers I I ' D Pullets ' D Turkeys Other D Turkey Poults D Other I ··---· Number of Structures: D IDother Ji Discharges & Stream Impacts L Is any discharge observed from any part of the operation? DYes ~No DNA ONE Discharge originated at: D Structure D Application Field D Other a. Was the conveyance man-made? DYes 0No DNA ONE b. Di d the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No DNA ONE c. What is the estimated volume that reached waters of the State (gallons)? ~ 11'113 I d. Does discharge bypas s the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of th e operation? 3. Were there any adverse impacts or potential ad verse impacts to the Waters of the State other than from a discharge? DYes . No DNA ONE DYes IKI No DNA ONE DYes ~No DNA ONE 11118/04 Continued · J Facility Number: '" -Date of Inspection I~ -(0 -DJj Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes f21.No 0 NA 0 NE DYes 0No DNA ONE Structure 5 Structure 6 \\R! It I '-vi'L Identifier: _ ___._u.....L! ----!-_ ___:.~~~-------------------------------- Spillway?: Designed Freeboard (in):---------------------------------------- Observed Freeboard (in): ---=8~t=--"--_ __,:1.::;;....,..,_" ______________ ------------ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) DYes [l51No DNA ONE 6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application ( 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? llQYes 0No DNA ONE DYes ~()No DNA ONE DYes ~No DNA ONE DYes ~No D.NA ONE II. Is there evidence of incorrect application? Ifyes, check the appropriate box below. DYes ~No 0 NA 0 NE D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area '-. ?) /I fl. 'I 1'/'{ f6 12. Crop type(s) 13t~IIMuJ,, J/.4 ~ &ra, S B I /vlu..T,, $m-1/ t8v1;., 13. Soil type(s) A.., No a I 14. Do the receiving crops differ from those designated in theCA WMP? 15. Does the receiving crop and/or land application site need improvement? DYes 0No DYes ~No 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre deterrnination!D Yes ~No 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? DYes [iNo DYes ~No DNA DNA DNA DNA DNA ONE ONE ONE ONE ONE Reviewer/Inspector Name Reviewer/Inspector Signature: Phone: 'ftO -18t,.-f54/ £., '}Jr Date: ~-Jo-oJ 11128104 Continued , I Facility Number: X'.2. -'-'lij Date of Inspection I ;J.. -tv-~Sj 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 ~ D ~ D Other 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes rENo DNA ONE D Yes !;gl No 0 NA 0 NE DYes ~No DNA ONE D Waste Application D 'J/eikly ¥Fe0eeMfl D Waste Anaiysis D s~il A:fl8l~·sis D Waste Transfers D ARRI:tfti CeRiiieatton 0 ~ 0 Steekiftg 0 Crel" Vietti 0 i2EI Mittttte IRSJwctiomo 0 Meftthly and 1" Raic lnSfJI!GtigJlS 0 We~er Cede 22. Did the facility fail to install and maintain a rain gauge? DYes [ll No DNA ONE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes (XI No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes lXI No DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes IXJNo DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance ofthe permit or CAWMP? DYes IX! No DNA ONE 29. Did the facility tail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? DYes ~No DNA ONE 30. At the time of the inspection did the facility pose an odor or air quality concern? DYes lXI No DNA ONE If yes, contact a regional Air Quality representative immediately 31. Did the facility tail to notify the regional office of emergency situations as required by DYes []No DNA ONE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes IX! No DNA ONE 33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE 12118104 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation Reason for Visit c{ Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other D Denied Access t...._ __ F_a_ci_li_ty_N_u_m_be_r_I_K_g. __ H __ ,_1_2. ___ --JI Date of Visit: I Lf/').3/ot hime: I fJ: co -. lo Not Operational 0 Below Threshold [(Permitted !!(Certified C Conditiooally Certified C Registered Date Last Operated or Above Threshold: ........................ . Fann Name: ........ ~J~!~ ............ B.:; .. ..f~t= ....... _ .... -............ _ .. ,_ ............ -........... County: -~~"' -----------··-·-·-·-·--· Owner Name: -~~-~:-::_ ........................ JY.i!1.i.~~------·-·--··---.............. Phone No: __ .1..~ .. ::-5' 4-_:._t.t!_~~----------·-·--·-·-·-· Mailing Address: .. _!1!.J... ...... ~~~-~~~ ....... &L .................... _................................ .. .. ~k.~-----(j_~---·-----------·· g_~~ ~-- Facility Contact: ··-·-·~--~-~-.Hl~!. ____________ Title: ....... f!M~~~ ................. _ .. _ ...... -.... Phone No: -·-------·--·--·-.. Ons;te Rep.....,.tativ" __ ,{~4;-io'~!l_r~L------·------·-·--·----Integrator. -~_,...-~J---·----- Certified Operator:·-·-·-·----~ .... -...... -~!:!.~~~?..---·----------·-......... Operator Certification Number:-------·---· Location ofFarm: Bswine 0 Poultry 0 Cattle D Horse Latitude ~....--.~1• ._I _ __.I• ._1 _ _.I" Longitude ~....-___.1• L-1 --l'' L-1 --l'" oc; $'3.oS Discharges & Stream Jmpacts I. Is any discharge observed from any part of the operation? Discharge originated at D Lagoon D Spray Field D Other a. If discharge is observed, was the conveyance man-made? b. If discharge is observed, did it reach Water of the State? (If yes , notify DWQ) c. If discharge is observed, what is the estimated flow in gaVmin? d. Does discharge bypass a lagoon system? (If yes, notify DWQ) 2. Is there evidence of past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Waste Collection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? D Spillway Structure 1 Identifier: ......... _ .... 1.. ............... . Structure 2 J... Freeboard (inches): ----lif-~1=----]{;, 12112103 --~--- Structure 4 31 Structure 5 DYes~ DYes DNo DYes DNo DYes DNo DYes urNo DYes ~0 DYes ro& Structure 6 Continued 'jFacili;y Number: ~~ -l1;l l Date of Inspection I 't/..23/ocf I 5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, seepage, etc.) 6. Are lhere 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 lhe structures need maintenance/improvement? 8. Does any part of the waste management system olher than waste structures require maintenance/improvement? 9. Do any stuctures lack adequate, gauged markers wilh required maximum and minimum liquid level elevation markings? Waste Application 10. Are lhere any buffers lbat need maintenance/improvement? 11. Is there evidence of over application? If yes, check the appropriate box below. D Excessive Ponding D PAN D Hydraulic Overload D Frozen Ground D Copper and/or Zinc 12. Crop type t!rto\"ck 511"1 4 11 13. Do the receiving crops differ with those design ted in the Certified Animal Waste Management Plan (CAWMP)? 14. a) Does the facility lack adequate acreage for land application? b) Does the facility need a wettable acre determination? c) This facility is pended for a wettable acre determination? 15. Does lhe receiving crop need improvement? 16. Is there a lack of adequate waste application equipment? Odor Issues 17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below liquid level of lagoon or storage pond with no agitation? 18 . Are there any dead animals not disposed of properly within 24 hours? 19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, roads, building structure, and/or public property) 20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately . tror I·Ot'k 'k k ;.... rJ ~ c ~u rr;s ~ ; V"CI l'lt&o+ fk..t.G Reviewer/Inspector Name Reviewer/Inspector Signature: 12112103 .... :.....;. DYes t2f'No DYes I!:JNo DYes l!J1ifo DYes ~0 DYes rn'No DYes [B1iio DYes ~0 DYes (g1fo DYes [91(o DYes ~0 DYes gflo DYes fii'No DYes lil'No DYes Giro DYes gNo DYes [i(No DYes fit No Continued • I Facility Number: ?'2 -'?1-.j Date of Inspection I Lf/P f "'t I 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? (iel WUP, checklists, design, maps, etc.) 23. Does record keeping need improvement? If yes, check the appropriate box below. 0 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 Reviewer/Inspector fail to discuss reviewfmspection with on-site representative? 28. Does facility require a follow-up visit by same agency? 29. Were any additional problems noted which cause noncompliance of the Certified A WMP? NPDES Permitted Facilities 30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) 31 . If selected, did the facility fail to install and maintain rain breakers 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 fonns need improvement? If yes, check the appropriate box below. 0 Stocking Form 0 Crop Yield Form 0 Rainfall 0 Inspection After I" Rain 0 120 Minute Inspections 0 Annual Certification Form DYes DYes DYes DYes DYes DYes DYes DYes DYes IHYes DYes DYes DYes DYes DYes I m' No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. 5~c ~ lh..,..~~J R~.,, 6fl;L ~-kJ L•"'""C Jtrr'1t!d ~ f;loo !Ls )t. <fo ~c I J'> r-7o,J ~ 4-11 wtJI ~11--~~ ~ :VI ~ 12112103 ~0 ~No [!(No [!(No BNo [!(No r!fNo (3"No [i(No 0No B'No [B"No urNo [B'No BNo 8 Compliance Inspection 0 Operation Review Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other D Denied Access .._ __ F_ac_i-lity_N_u_m_b_e_r _I _K._.2.._H __ c __ z_z __ l __ ..... l Date of Visit: Below Threshold • Permitted II Certified C ConditionaUy Certified C Registered FarmName: &J,/!-,_.,_6 dT ~- Owner Name: ~ -tf ~ a~,~ Date Last Operated or Above Threshold: County: S~cr..J PhoneNo: ----------------- £J?£6P..c.o , !Ve-Mailing Address: I 7?9 /5A-:s;:r All--kn ~ Facility Contact: ~ ~,g~ Title: -----------Phone No: -------:---- Onsite Representative: Z,. ~~.,;;tt._$" Integrator: .~~ ~ 7 Certified Operator: K "Y' b).~ Operator Certification Nnmber: Location ofFarm: Discharges If Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge orig inated at: 0 La~oon 0 Spray Field 0 Other a. If discharge is observe d, was the conveyance man-made? b. If discharge i s observed, did it reach Water of the State? (If yes, notify DWQ) c. If discharge is observed. what is the estimated flow in gal/min? d. Docs discharge bypass a lagoon sys tem? (If yes, notify DWQ) 2 . Is there evidence of past dis charge from any part of the ope ration? 3. Were there any adverse impacts or potentia l adverse impacts to the Waters of the State other than from a discharge? Waste Collection If. Treatment 4 . Is storage capacity (freeboard plus storm sto rage) less than adequate? D Soillway Identifier: Freeboard (inches): 05/03101 Struc ture I S tructure 2 Structure 3 Structure 4 Structure 5 DYes ·~No DYes Ja'No DYes 'RfNo DYes ""S"No DYes ~No DYes ~No DYes ~No Structure 6 Continued ,_ [Facility Number: ~Z. -~7Z-l Date of inspection 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ tree s, severe erosion, seepage, etc.) 6. Arc 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 bealth or environmental threat. notify DWQ) 7 . Do any of the structures need maintenance/improvement? 8. Does any part of the waste management system other than waste structures require maintenance/improvement? 9 . Do any stucturcs lack adequate, gauged markers with required maximum and minimum liquid level elevation markings? Waste Aoolication I 0. Are there any buffers that need maintenance/improvement? II . Is there evidence of over application? 0 Excessive Pending 0 PAN 0 Hydraulic Overload 12 . Crop type he-J?m~, .c~#'A-~; St?f ~' ~ 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? Reoujred Records & Documents 17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? 18 . Docs the facility fa il to have all components ofthe Certified Animal Waste Management Plan readily available? (ie/ W"' ch~sts, d?"ma~etc .) ~ J 19. Does record keeping need improvement? (ie/ irrig"lltion , freeboard, wastc:nalysis & soil~ reports) 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 21. Did the facility fail to have a actively certified operator in charge? 22 . Fail to notify regional OWQ of emergency si tuations as required by General Permit? (ie/ discharge, freeboard problems, over applicati on) 23. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? 24. Does facility require a follow-up visit by same agency? 25 . Were any additional problems noted which cause noncompliance of the Certified AWMP? DYes ~No DYes )8:No DYes ~o DYes 'R"No DYes JRNo DYes ~No DYes ~No DYes i,1No DYes ~No DYes WNo ~ ~Yes ~oJL-Y t><f DYes ,;KINo DYes ~No DYes tR(No DYes ~No DYes No DYes ;~· DYes No DYes ~No DYes ~No DYes ~No DYes jfJNo C No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit ~/.:r -,f R£-a~ L~(2:1',....; #..? /1 /~LJ?V/-,. ~p ?_1(!_-"'.r.Je&v£~, ~: /'~--/_;/~etc/~ be/~ ~ ~,/£' 4 ·?f% pk /1,/cl ,(/c/~ ~-;,.pey..~ Reviewer/Inspector Name Reviewer/Inspector Signature: 05103101 Continued .. I Facility Number: ~z. -d'?z I J>att>oflospection J6/4/o21 Q.dill: Issues 26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below liquid level of lagoon or storage pond with no agitation? 27. Are there any dead animals not disposed of properly within 24 hours? 28 . Is there any evidence of wind drift during land application? (i .e. residue on neighboring vegetation , asphalt, roads, building structure, and/or public property) 29 . Is the land application spray system intake not located near the liquid surface of the lagoon? 30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or or broken fan blade(s), inoperable shutters, etc .) 31 . Do the animals feed storage bins fail to have appropriate cover? 32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Ji'l Yes D No DYes ~No DYes ,M'No DYes ~No DYes p(No D Yes ~o _){Yes 0No :AdditionaiComine.nt~:aniJ!.~r,:J.l.i:awings:_~~ _, ,;>, •.r: ... ·~._;ro . .i;.·~'~'-'·:~~4l:f.-~"$4~:'i~li~ti~~fif-""!rt'r'..:-v,,·~·~-:i~~f·".·~-'cT.~>:,i.;.~~~~~~ .•. 05103101 ... 1- Site Requires Immediate Attention: __ Facility No. ¥':2-~3~ DMSION OF ENVIRONMENTAL MANAGEMENT ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD DATE: _J uf ..( / 8' 1995 I Time: 11 ~a Farm Name/Owner: /{ /M €1-:N J (,/}_ IJ. J W; 1// A A1 5 Mailing Address: d i . ·p$a 'IS' tf, /2d 5E~(),e/v. ,.yc: zp~2-- County: 1k&f'So~ ' Integrator: £'/) r /{.·'T't "t("e.,.~o..b" Phone: ______________ _ On Site Representative: t..:-1) K-'--v ~ Phone :____,,.----~----:------ Physical Address/Locatiop: r(!li.c:')&=·J "LLf W' cj,•.-y~uN-'" ~.At: Tu,<./V loL~r ,'/f/ /to.v.tJ-:, (lf le-tJ ,,,,fo Sll /~ 33 _! ,CJ9M t':? IY-z-)i,'k$ pN' ~~+-h Type of Operation: Swine L7 Poultry __ Cattle--------.,.----,---....----- Design Capacity : Number of Animals on Site: 2 J 1-0 Cr-=>At-/.5 6) DEM Certification Number: ACE DEM Certification Number: ACNEW ______ _ Latitude: __ o __ • Longitude:_ o _._. (jtJ>/ te..,_3-"' Y-t-z -tJ Y'-tr Circle Yes or No · Does the Animal Waste Lagoon h~] sufficient freeboard of 1 Foot + 25 year 24 hour storm event (approximately I Foot + 7 inches) YeS or No Actual Freeboard: .S Ft. ~Inches Was any seepage observed from the lagoon(s)? Yes or NC9was any erosion ob~ed? Yes or~ Is adequate land available for spray? e or No Is th~ cover c~QP adequate? ~or No Crop(s) being utilized: I':~ riJ.-1 J11J t:IZJ1fu /)ff Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? ·' or No 100 Feet from Wells? @s or No Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or tliJ1 Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or@ Is animal waste discharged into water of the state by man -made ditch, flushing system, or other similar man-made devices? Yes or No) If Yes, Please Explain. Does the facility maintain adequate wastVrnanagement reco;:d.h(volumes of manure, land applied, spray irrigated on specific acreage with cover crop)? ~Sior No Additional Comments: ____________________________ _ Inspector Name Signature v cc : Facility Assessment Unit Use Attachments if Needed. .. . \ IIORTB CM.Ol.l::D DEPARTIII!ST OF EHVXRONIIENT, BEALTB· & HATUKAL RESOORCES DIVJ:SION OF ENVIRONMENTAL IIARAGEIIEN'.r Fayetteville Regional Office Ani.Jital Operation compliance Znspection Porm All questions answered negatively will be discussed in sufficient detail in the·Comments Section to enable the aeemed Permittee to per=orm the appropriate corrections: SECTION I Animal Operation ~:Finish Horses, cattle~ poultry, or sheep SECTION II 1 . Does the number and type of animal meet or exceed the (.0217) criteria? [Cattle {100 head), horses (75), swine (250), sheep (1,000), and poultry (30,000 birds with liquid waste systCim) l · 2. Does this facility meet criteria for Animal Operation REGISTRATION? 3. Are animals contined fed or maintained in this facil1 ty for a 12-month period? 4. Does this tacility have a CER'tl1'IED ANIMAL WASTE MANAGEMENT PLA1i? 5. Does this !acili ty maintain waste Dlanagel!leDt records {Volumes of manure, land applied, spray irrigated on specific acreage ~ith specific cover crop)? 6. Does this facility meet the SCS minimum setback c:iteria for neighboring houses, wells, etc? y N COMMENTS v J ( ~ ;3 J I _....,. fBC'nDR XII tield Si~e Managemqnt 1. to anilll&l W.t!alw HlUC:kS'1lM 01' lagOOA construction within 100 ft. cf a uses Map Blue Line Stream? 2. Is animal waste land appliwl or •pray irriga~Qd w~~hin 25 1\. ef A UOGO Map Blue Line Stream? 3. Does this facility bave adequate acrea;a on which to apply the waate? 4. Does the land application · site have a cover crop in accordance with the Cll!'l'IJPICATIO!! PLAR7 5. Is animal waste diachargad into vaters of the state by man-made 41teh, flushing system, or other similar man-made devices? 6. Does the animal waste management at this farm adhere to Best Management Practices (BMP) of the approved <:pnn<;A'l'IOff? 1. Does animal waste lagoon have .uffieient freebOard? How much? (App~ximately ) .8. Is the general condition of this CATO facility, including management and operation, satisfactory? SJ:CriOI! IV eomments y • .: ·. "" ?~G:S~?-~7:CN =c~~ =oR ~~!~~ =~~~L07 OP~?~!!ONS Depa=-~en~ of ~~vi:~nmen~, Eeal~~ an~ Na~u:al Resour~es Division of ~~vir:r~er.~al Manaqemen~ Wa~er Cuali~y Sec~i~n !! ~=:e ar.i.::al ;.ras~a ma.na<;emen~ sys~~!!t f~r ycu: !eeC:lc~ opera~icr. is desi~eC ~= se~re mere ~::.ar. o: a~al. ~~ lOO heaC. of c.at::!.e, 75 horses, 2:0 s~i~e, l,aoo shee~, or 30,000 bir:s c~a~ are se~rec by a liq1.0i~ ~o~as~e sysr.am, c~en :.=:is !cr=t inl.!sr. ::::e fill~C. Ot!~ and ::1aileci by Dece!tt!:e: 31, 1.9;3 ;:ursua.""l~ :.: ~.:.;. NC.;.c 2.:-:.az: i (cl i!l o=::e: ~= be deemeC ~e=-=~~~ee by D~~. ?lease p=~~~ c!ea:~y. ~:u.-: c ::· :---"""'~J ~P-..,]'..A-.;;.;~.\C~·CJJ'-~· ,__j,__ ______ ? hone Nc ·------- \-<, ·~ r--\-~i~~ \_. b<:<.~~. CwnerCs ) Name: Mana~erCsl Name : _____________________________________ __ ,Lessee Name : _______________________________________________ ___ =a.::n Locat:ion Oesi~n capaci:.y of animal was~e manaceme.nc sys"Cem (Number and ~ype c: c~nf .:.nee a.n~=tal < s J ) : _____ _.r-.::?"'t...,o .... -.... C .... > --------------- A'Jerage ani:nal ccculat:.ion en t.he far:n (Numi::er and ~ype of animal (S) .raised.) : -\DM 'E-~5 ~~Q\JE; .":{ Year E' roc:.!c~icn 3e<;an: 19<t5 ASCS !rae-:: No . : T r2, t { / Type of Wasr.e Manac;emen~ Sys~em Used: 1 <~ 1!;(~ l~llf"Ct\J Acres A'Jailable fa= Land Application of Was~e:~&2~~"~~----------------- Owner(s) Signa~~=e<sl .\L.:_ DIVISION OF ENVIRONMENTAL MANAGEMENT ' Compliance Inspection )1 d, ')ffl,odo!t;-"1 j County i-9-<1jJ :5CJ N Dear : ~ q _,-. 1-(u-S On , , an inspection of your animal operation was performed by the Fayetteville Regional Office (FRO). Please find enclosed a copy of our Compliance Inspection Report for your information . It is the opinion of this office that this facility is in compliance with 15A NCAC 2H, Part .0217, and that Animal Waste Management is being properly performed. Should you have any questions regarding this matter, feel free to contact me at (910) 486-1541 . GD/ Enclosure cc: Facility Compliance Group Sincerely, () I ({dAti! 7 { h...PA', 'sr Site Requires Immediate Attention: __ _ Facility No. _:(:------ ' DMSION OF ENVIRONMENTAL MANAGEMENT ANIMAL FEEDWT OPERATIONS SITE VISITATION RECORD DATE: fuf <.../ Jf , 1995 I I Time: II 'JO Farm Name/Owner:~r--1'--'--±-<-"<+-----7........._-::-'-..;;__~-._L..---------r-----,-~~---...:.-/ Mailing Address:7"""":?=-'--7r-~:....=..:~~..........c....=.....o:....~::...-~=r-~-~~~~~.I.I!:.-...LJ:f!:....;:._..:.L......:..9...:.~....::.~ __ _ Coooty : ____ ~~~~~~--~--------------....-------------------------------lntegrator:_......_=~~~-..L......e.~~-'-------Phone: ______________ _ On Site Representative: t?R , I(•'...YC Phone: _____________ _ Physical Address/Location: __ ~~l<----""6~' I.....;;Z..;._~-'J=-----..._ ____________ _ Type of Operation: Swine V Poultry __ Cattle ~ Design Capacity: Number of Animals on Site: 1-:2-C1) ( Frflfr'1C "- DEM Certification Number: ACE DEM Certification Number: ACNEW ______ _ Latitude: __ o __ __.. Longitude:_ o _._ .. Circle Yes or No Does the Animal Waste Lagoon h~sufficient freeboard of 1 Foot + 25 year 24 hour storm event (approximately 1 Foot+ 7 inches} ~r No Ac_wal Freeboard: & Ft. __ Inches Was any seepage observed from the lag~n(s)? Yes or NOlwas any erosion ob~ed? Yes or Q Is adequate land available for spray? ~ or No Is the cover crOP. adequate? tes or No Crop(s) being utilized: (' J > 1. !h-I t?!U-< U '{)If- Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelling~~ or No 100 Feet from Wells? ~r~o . Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or NOJ Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or~ Is an~m~ waste discharg~ into water o~,!.hr state by man-made ditch, flushing system, or other s1mllar man-made dev1ces? Yes or~ If Yes, Please Explain. Does the facility maintain adequate waste management reco!'4. (volumes of manure, ]and applied, spray irrigated on specific acreage with cover crop)'? ®1 or No Additional Comments: _____________________________ _ Inspector Name Signature v cc: Facility Assessment Unit Use Attachments if Needed . • t lfOR':B CUOLIRA DEPAR1'JI!2ft" ()IP ERVDlONKI!!Nr, HEALTH· & HA'l"'KAL lUI:SOURCES DXVLSION Ol" ENVIRONMEN'1"AL IIA!IAGEIIENT Fayetteville Regional Office Anil!Ull Operation Compliance :Inspection Porm All questions answered negatively will be discussed in sufficient detail in the ·Comments Section to enable the deemed Permittee to perform the appropriate corrections: SECTION I Horses, or sheep SEqiON II 1 . Does the ntl.lllber and type of animal meet or exceed the (.0217) criteria? [Cattle (100 heaa), horses (75), swine (250), sheep (1,000), and poultry (30, 000 birds with liqcld waste systCUD) ] • 2 . Does this facility meet criteria for Animal Operation REGJ:5TRATl'ON? 3. Are anilnals confineCI fed or maintained in this facility for a 12-month period? 4. Does this facility have a CERTIYP!D ARniAL WAST!: )(ANAGEMEHT PLAft'? s . Does this facility maintain waste ~anagement records (Volumes of manure, land applied, spray irrigated o~ specific acreage ~ith specific cover crop)? 6. Does this facility meet the SCS ~inimum setback e=iteria for neighboring houses, wells, etc'? y N COMMENTS v v [/ v v ( . SBC"nON nr Pield Si~a Hanage=ent 1 . Is anitllal waste stockpiled or lagoon construction within 100 ft. of a USGS Map Blue Line Stream? 2. Is animal waste land applied or spray irrigated within 25 ft. of a USGS ~P Blue Line Stream? · 3. t)oes this facility have adequate acreaqe on which to apply the waste? 4 . Does the land apPlication· site have a cover crop in aecoraance'vith the CERTIFICATION l'I.AM? 5. Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other similar man-made devices? 6. Does the animal waste m.ailagement at this farm adhere to B~t Management Practices (BMP) of t!le approved Q!R!IYI<;ATION? 7. Ooes animal waste lagoon have sufficient freeboard? How much? (Approximately ) 8. Is the general condition of this CAFO facility, including management and operation, l!l&tisfactory? SJC'TlON rv Com11lents y R COMM!!N'l'S l ! ! -. ,._ .-.,.-I' • .pu: =--··::a 0 . \) \ . \..· . . . "' ... . ) .. . \ .~·· . \' ~ .. ~. I . . .. ~~-··== •• ..... c:at17%CA'n011 .. --P7D 311 ... ~ . . ..: .. _ .. . Jr1 .... •• en 1 at ... --. ~ 1ti•t•bi .. at· ~~•1 ..... -ac ac · tM ... :·!~t!: ...... -....... .,~-f.... :... . ..... ·'·· . ., . .,. ....... ~ ........ .. ,.._ of-~ ~1~· ---:;;~; .. )'·.~ )r--\'.\\·,~~ .---.~- Wr .. a t Q-;-. \ Q,ol< $1\,--c:;---.. , Qo-?~._ .... "tl.~. ¢]3-&~ Phone No. : 51 o -S!,'\--~'\'lo , Count:y: $*='il;.v~ Fans loc:at:ion: L&t:itwie .&nCi LonQ'it:ude:li• U . .' ll"/Z£0 jl' ~ .. (rac;ui:eci). pl .. •• &t:t:&c:h & ~opy o! a c:ounty road map with loc:ation i~enti!ied. Also. Type of oparacion (awina. layer. ~rJ. atc:.):~-5~~~~~~~~~--------------------- De•ign c::spac:i::y (m..zmi:ler of ani.mala): Z "'Z.o 5 Fereg-Frn 1 !.fJ Averac;e si:e o! operation· (12 ~nth populat:ion a.vg.): Z 2.05 FeED-r:-,·.,sH Averac;e ac:r .. ~e need-.d for land &;~plic:ac:ion of waace <•c::-as) a 4-5 A c. ···---·-·········································--···········-··············· ~ec~~~ 8pea~&1~a~ ~~~o•&~ .. Aa a eac:hnic:al ~ialisc c!esi¥-l&ted by · the No~h. Car::lli:-..& Soil anc! Water Consarvat:ion Ccmaisaion .,urauanc co l.SA ~C 6F • COOS, I c:a:-:i!:t :.!la~ t:.'le :lew or ~a..~::iad an.i:&l waste m.e.n.ac;...r.~ syseaa as· inst:alled for :.~e !a:::t nameci above -~. ---· h&.s an animal ,.,..t:• lMC.aq...nt: plan th&e meats the dasi~. cons~:'IJ.c~ion. operation ar.d. m&ineeD&nc:e at&Dd&--ds a.nc! spac:i!ic:at:ions o! the Division of :;nvironmental Ma.n.aq.-ne and t.."ie tls::JA-Soil Consar.ration Se::-ric:e and/or t:~e Nor=h Carolina. Soil and W.ter Consar.r.at:ion Commisaion .,ursuant: :.o lS~ NC.C 2H. 0217 and lSA ~c 6F .0001•.0005. The follcwi~~ elements a.nc thai:-c=~~esponc!inq min~ c:=i~aria-~_verified by :. or oe..'lar d.esiqnaead t:e<:."'.nica.l .spec:ial.ists. ~- ar• inc:!uded in t:he plan as applic&Dle: minimum ·~ations (!:n.:.!!cs) r liners ·or equ:ival.anc for lac;oons or wast:•-scorage poncla: waata st:ora~e c:apac:;:y;.adec;uat:e c;u&ntiey &:24 amcnmt: of land tor wast:e utili.:ation (or waa of t:hi=d pa....~): ac::eas or ownership o! proper waate appll.eat:ion equi~t:; ac:."1edl4le· ·for~tilainq of applieac:iona: applic:at:ion rat:-; loading rat:-; and the conerol of t:ha ella~• of pollu~a frail aeo=--at.ar ::'UilOff ~t.• l .. a sever. than t:.he 25-year .•. l4.-hfNr st.or.a • .._ ·~ ~-ical. .... ialU1: (Pl-• Print): G. GL£n n C&l FTor, M!ili&~ion: f?R~-rA~ :::Alk?'1r Inc.. ~••• (AQ'e-"l<:"J') :)>. o 4-3 Phone No . 2::110·592..-S 77/ Si~nat.-.aa: s!f <i4, · C..~'t:O:.-C..ta: 1/"f-/95 --·-·············--············--····································· Owuer/X&zaa~ ~---~ I (we) understand. the operation and mair.eananca procedures est:ablish-.d in the approved animal was::e manac;emenc plan !or the f&r.tl named. &Dove and. ~ill im;ll-=-ne t!'lase :;::=-oc:.C:u:es. ! (we) k."low t:!'lat: &rr'f ad.ai~ional axp&r.aion ~o ·the exiseinc;-- desic;n c:apac:i~/ of t!le ~aste e:eat::ten<: a.nc! se~rac;e sys:aa ~r =~nsc:-uc::ion of n..., fac:ilit:ies will require a n.w ce~i!ieat:ion to ~ submit:.C ~c ~"1e Oivision of ~vi::.nmencal M&nac;e!Dailt bef:~re che n.w ani:Dals are s::~c:xad. I (we) also und.ers:.and t:hae there :nust: be no dise~ar;e ~f animal waste !:~m ~"'lis syst.aa co surfaee waters of the sca.ta either c~rou~h & man-oace :::l~Veyanc:e ~r thrQUqh ~~nof! !~o~· a. s:o~ event less severe than the 25-yea:, 2•-no~~ sto~. The approved plan will be ~iled at: t~e !a.--:s and &t c~a of!ice c! :::.·e local Soil and Water Conservation ~iseric::. N-.. o~ L&Dd OWDer (?lease P:L"lt:}: ___ ~~~~C:~--~~~:~\\~;~o~"'~}~----------------------- 1 J. • \. • Siqnacu:e: .-6..---. I...J....J~ C&te: 1 /o<~,.-/~ Jr..-o~ K&n&q.r, i! di!fe:ent. !:om owner (Ple&se print)=------------ Signacu:e : \..6.:-W .J.lj.... • Date: \ f=>q..f~~ ~: A c:~~e in l&nd ownership requires no~i!icat:ion or & n.w cer~i!icat:ion (i! the approved. plan ia c:h&nqed} to be submi~t:ed. :o c~e Civi1ion of Enviror-~ental Manaqament wit:hin 60 d.ays of a ti~le transfer . . 0~ USE CN:.'f:AC~,.·------------ .. Deportment of Environment, Heottn and Natura Retot~ces Oiviaion Of ~irOI'VT\~l Mcnaa.ment Janes I. Hunt, Jr .• Governor Jcnaihcn B. Howes. Secretary A. Preston Ho..tord. Jr •• P.E •• Dtlect0t c:a~±?ICA~:oH POR N:K ga :XZAKCZP AHAXAL PIJPLOTS ZNsnuc:-:cNS FOR CDT:FICATION OF APPROVED ANIMAL WAS'!"E MANAG~ PLANS FOR Nr..J OR E:xi'ANDC AN::MAL WAS'!'!: MAN:.CEME:r:" SY~ SElt~ n:z:lLO'I'S !~~~es~st~s. !!l order t::~ ~ deC~~ed i)e:::li~-=.ed by the Di~.risi~n of Envi:ol"'.mlln~&l Ma.naqament: !CEM> , the avner of ar.y n...-or ~cied ·an.;,m.al wa~:• ma~ac;emenc syscem c:Qn.at:uc:aci altar J'&nu.&.r./ l. 1994. whic.~ is desiqned to ser.re ~reater t!l&r:. or ~l :::~ :he an.i;u.l ;Jopulationa lisc:ed ~low is rec;uireci to submit & si~ed c:er:i!ication !or.: eo OEM beta:-~e n.w an.i.:Dals are •tocked on the !&r.:~. ?u::J.:a operations ~· exempt !:-om ~~• requi:--.nt to be cer<:i!ie<!. 100 head o~ ca~~~· 75 ~ ... . 250 ...-1- 1, 000 sJae,ep 30,000 ll.t:d.· v1CJa & ll~ ...ca ~ The carei!ic:ac:ion ~t be sigfted by the ~ of the !...Uoc: (and ~er i~ di!farent !rcaa t.he owner) ~by any t.cmi.c:al spec:ialbt c!uignateci by the Soil. aDd Water Con.e:J:"V&C:ion C:~ssion pursuant to l!A NCAC 61' • 0001-.0005 . A tecbftical specialist must verity by an oa-sic:e in.paction th&C: all applicable de.i~ and. consC::"Uction stand.arda and. ~i!ic:ations are ID8C. aa insulled .nil! Ch&c all applicable operacioa and ~taft.nee sc&ndards and apeci!icacions can !)a met. Alt~qh t...~• actual m=ber of animals ae e.~a !.aeilicy :~~&y vary ~=QIZI time t:Q eiJDe. t.,_ design capacity of C:he wa.ste handlinG syse-shoulc! be u.ed to c!etens.i.De i! a far.= is subjec:e to the car:ifieacion requir...ae. For example, if t.~e ~t• system !or a !e.C.:oc. is deaiqned to ~cile 300 l:loqs but the .avaraqe .,opul.ac:ion will ~. ~00 ho;s, t...~en the waAte mar~..-nt syac.em requires a certification. '!'!lis c:e:-ei!ic.ation is rec:ui:ad ~ rec;ul.ations gove..~in; anica.l waste mana~Wamene sysccns &<!opead ey the Znvi:onment.al M.an&q-=ant C==aisaion (~C) C!l Cece\be: 10, lH~ (Tit:.le lSA NCAC ~H • 0217}. s;::c::?·a. ~gx roax Cn ::.~a .reverse siC.e of this ;laqa is t~a ce.r:i!icac:..on !!l::;::t which z::u.s: !:le s'I.O.!:=Ii.::e-::! to ~~ !:le!l:l.re :1ew a.ni:::.als a..ra stoc:kad on :he !a_~. Assiscar.c:a i.."'l c~lati~q ~he !o~ can be obtai..~ed !r::~m one of t~a local aqri~~lt~ral ac;ar.c:ies suc:h as ::~o:e soil ar.d wacar cor:.serva.~ion dis~.ri::. che t1SOA-Soil C:maa:-Jacion Sar.,.i:e, or t:ha N.c. C:oo;:ara:ive ~tension Serric:a. ':'he for= shoul~ ~e se~t to: Oe?ar~ent of E."'lvi.ronment. Haa!th and Nac.u.ral Resou::-:es Division of ~~viror~ental M&naq-=ant water ~ali~f Section. Planninq 3ranch P.O. Box 2g535 ~~ R.alei~h. N.C. 27646-0535 Phone: '19-733-5083 ·1 ~ Stave W. Tecicer. Chief Water Quali:y Sec~icn For. IO: A~~Ol9t C&c.e: /l.,. -: .z... ~r1 P.O . Box 29SlS. ~defQh. North CO'oir,~l~762~ Taleohone 9l9-733-70lS FAX 9 1 9·i~3 ·2496 Arl ~ 0~ Ar.'ITTie:v. ~ ~ S...~rec:yded/10'1. par~ons.mer poe., , ; . -