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HomeMy WebLinkAbout820674_INSPECTIONS_20171231NORTH CAROLINA Deparbnent of Environmental Quality Farm Name: N u r....sz:-1'""7 Owner Email: Owner Name: :DaA--, rJ 5 Phone: Mailing Address: Physical Address: Facility Contact: 1Jol[l1a f=k i rc.. ~-ti_ Title: &.eJ h ..-r Phone: Onsite Representative: Integrator: tfJe/tf&lrl r Certified Operator: # dYL·, 'r I s Ea : r-c_l (2 ~ Certification Number: /9-.e.3:C Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts I . Is any discharge observed from any part o f the operation? DYes ~o DNA ONE Discharge originated at: 0 Structure 0 Applicati o n Fi eld 0 Other : a . Was th e conveyance man -made? DYes 0No DNA ·O NE b . Did th e dis charge reach waters of the State? (If yes, notify DWR) DYes 0No DNA O NE c. What is the estimated volume that reached waters of th e State (gallons)? d . Does the di scharge bypas s the wast e management system? (If yes, notify DWR) D Yes 0No DNA ONE 2. Is there evidence of a p ast discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a di sc harge? Page 1 of3 0 Ye s DYes ~0 DNA ONE No DNA ONE 21412015 Continued !Facility Number: 72:-G:> 7Lf !Date of Inspection: ?J:-z-?-IY'l I Waste Collection & Treatment ', 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes [J'Kio 0 NA 0 NE 0 Yes 0 No 0 NA 0 NE a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? Structure 5 Structure 6 DYes EJ1fo DNA 0 NE DYes c:rN'o DNA D NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the 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 Aoplication I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes~ DYes~ DNA ONE DNA ONE DYes ~o DNA ONE DYes ~ DNA ONE 1 I. Is there evidence o f 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 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 Approved Area 12. Crop Type(s): C.o~o'\. /wLJ-/5 7./-"".s 13. Soil Type(s): A;y Z[ 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. I s there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. DYes DYes 0 Yes DYes DYes DYes DYes ~ ~ ~ ~ DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE OwuP Ochecklists 0 Design D Maps 0 Lease Agreements 00ther: ___ .,..-_____ _ 21. Does record keeping need improvement? lfyes, check the appropriate box below. D Yes ~ 0 NA 0 NE D Waste Application O.wee kly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers 0 Weather Code D Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspectio ns D Monthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~ 0 NA 0 NE 23 . If se lected , did th e fac ility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~ 0 NA 0 NE Page2of3 21412015 Continued . I' • !Facility Number: &'/---0Z'f I Date of lnsl!ection: ?-?.?-1.8'1 ~ 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes DNA ONE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes ~ DNA ONE the appropriate box(es) below. 0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date offtrSt survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? 27 . Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? lfyes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains ex ist at the facility? If yes, check the appropriate box below. 0 Application Field D Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/ins pection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? Reviewer/Inspector Name: Page 3 of3 D Yes 0'No DNA ONE 0 Yes [3iio DNA ONE 0 Yes ~ DNA ONE 0 Yes ~0 DNA ONE 0 Yes ~0 DNA ONE 0 Yes ~ DNA ONE 0 Yes [2t'l'fo DNA ONE DYes Q-No DNA ONE DYes [31'lo DNA ONE Phone : Date: '77 P ~_5D.:ro; s I r-/.:z-~/y 21412015 DateofVisit:j r-2-/ZI Arrival Time:!'"/ :oc Departure Time: I I 0 ; ov I County: 5~ Region: -F'J!:. 7) -Farm Name: I r·,-pL c J2 Owner Email: Owner Name: J)a ""-~, r L Phone: Mailing Address: Physical Address: Phone: Facility Contact: Onsite Representative: Integrator: V;z,;z~J/ > Certified Operator: Certification Number: Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? 0 Yes g_No Discharge origi nated at: 0 Structure 0 Application Field 0 Other: a. Was the conv eyance man-made'? 0 Yes 0No b. Did the discharge reach waters of th e State? (If yes , notify DWR) 0 Yes 0No c. What is the estimated volume that rea ched waters of the State (gallons)? d. Does the discharge bypass the waste management system? (If yes, notifY DWR) DYes 0No 2. Is there evidence of a past discharge from any part 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 0 Yes .:KJ No 0 Yes J2i_No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 21412015 Continued !Facility Number: YjL. &Zijl loate of Inspection: 'X-Z-tz I Waste CoUection & Treatment -~ 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure2 Structure] Structure4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): Ji 5. Are there any immediate threats to the integrity of any ofthe structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes CLJ-No DNA 0 NE D Yes 0 No 0 NA 0 NE Structure 5 Structure 6 DYes ~No DNA ONE DYes ~No DNA ONE H any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~No DNA ONE DYes (2J_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 0._No D NA 0 NE 0 Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area 12. Crop Type(s): C 0"'1'\ !tv&J / £e;r./'l:?-. ( 13. SoiiType(s): ~-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 14 . Do the receiving crop:<J1er from those designated in the CA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack ad equate 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 readil y available? 20. Does the fa cility fail to have all components of the CA WMP readily available? If yes, check the appropriate box . DYes 62J. No DNA ONE DYes eg_No DNA ONE DYes JElNo DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes [iiNo DNA ONE DYes ~No DNA ONE OwuP O c he cklists 0 Design 0 Maps D Lease Agreements 00ther: _________ _ 21. Does rec ord keepin g need imp rov ement? If yes, check the appropriate box below. D Yes ~No D NA 0 NE 0 Waste Application D Weekl y Fre eboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Weather Code 0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Inspect ions 0 Sludge Survey 22. Did the fa cility fail to install and maintain a rain gauge ? DYes m No DNA 0 NE 23. If se lected , did the fac ili ty fa il to install a nd maintain rainbreakers on irri ga tion equi pment? DYes 0-.No DNA 0 N E Page 2 of3 21412015 Continued • fFacility Number: 5?--[, z J{ I Date of Inspection: 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. 0 Yes (i} No D NA 0 NE DYes aNo DNA ONE D Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels D Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Application Field D Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance ofthe permit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of3 DYes ~No DNA ONE DYes ~No DNA ONE DYes £2g_No DNA ONE DYes ~No DNA ONE 0 Yes I}J.No DNA 0 NE DYes ~o DNA ONE DYes ~No DNA ONE 0 Yes ~No DNA 0 NE 0 Yes (SlNo DNA 0 NE Phone: 9zo-...,dt>.?-o ~I Date: C,Z~Z 21411015 Date of Visit: I 'Z:?Hb I Arrival Time: I r: j D FarmName: JC/fl~ :0 Owner Name: D~ (c / 'A u c.f ~!:!"/· '-IV Departure Time:l /~.'30 I County: irz",.._ Region: /3lJ Owner Email: &~lotl Phone: Mailing Address: Pbysical A ddress: Facility Contact: -D-""-"'b:....:.n ..... n~o...=---_.8'---;4-~--,...._~_~_tl_·_ Title: Pbooe: Onsite Re presentative: Integrator: Certified Operator: C ertification Number: /ff:¥,2-le Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts 1. Is any d ischarge o bserved from an y part of th e o perat ion? DYes [gJlo DNA ONE Di sch arge o ri gin ated at: 0 Stru cture 0 Appli catio n Field 0 Other: a . Was the conveyance man-made ? DYes 0No DNA ONE b. Did the d ischarg e rea ch waters of the State? (I f ye s , noti fy DWR) D Yes QNo DNA ONE c . Wh at is the es timated volume that reached waters of the State (gall ons)? d . Does th e di sc harge bypass the wa ste man agement syste m? (If yes, notify DWR) D Yes 0No D 'NA O NE 2. Is there evi dence of a past disc harge from any part o f the oper ati on? 3. Were th ere a ny o bse rvabl e adv erse imp acts or potential advers e impacts to the waters of the State other than fr om a disc harge? Page I of 3 0 Yes 0 Yes ~No DNA O NE ~No DNA ONE 214/201 5 Continued • (F&cility Number: toz q I !Date of Inspection: 7-2J-/Ie 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: Spillway?: Designed Freeboard (in): I Observed Freeboard (in): 3b 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DNA ONE 0 Yes 0 No 0 NA 0 NE Structure 5 Structure6 0 Yes 5No 0 NA 0 NE DYes ~o DNA ONE lf any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental tbrea4 notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? 0 Yes J2l.No 0 NA 0 NE 0 Ye s fia_ No 0 NA 0 NE 0 Yes ~No DNA 0 NE 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 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Applicat ion Outside of Approved Area 12 . Crop Type(s): U/l't Uubf /5'7/,.-,....1 13. Soil Type(s): _....~.A-~~-v:.......:~:::P::...... ___________________________ _ I 14. Do the receiving crops differ from those designated in the CA WMP? 0 Yes ~No 0 NA 0 NE 15. Does the receiving crop and/or land application site need improvement? 16 . Did the facility fail to secure and/or operate pe r 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 & Pennit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. 0WUP Ochecklists 0 Design 0 Maps 0 Lease Agreements 0 Yes (2!No 0 NA 0 NE DYes [&No DNA ONE 0 Yes [la No 0 NA 0 NE 0 Yes ~No 0 NA 0 NE 0 Yes ~No DNA ONE 0 Yes ~No D NA ONE Oothe r: 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 NA 0 NE 0 Yes ~No 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 In spections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~ No D NA 0 NE 23 . If selected, did the faci lity fail to install and maintain rainbreakers on irrigation eq uipment? 0 Yes ~o 0 NA 0 NE Page2of3 21411015 Continued .!Facility Number: 8;¢= -~ 7 q !Date oflnspection: ,7-&lt. 24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes !liNo 0 NA 0 NE '• 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. DYes J8l..No DNA ONE D 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? Otber Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes , contact a regional Air Quality representative immediately. 30. Did the facility fail to notifY the Regional Office of emergency situations as required by the permit? (i .e., discharge, freeboard problems, over-application) 3 I . Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Application Field 0 Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? Reviewer/Inspector Name: R eviewer/Inspector Signature : Pllge3 of3 0 Yes ~No 0 Yes (2iNo 0 Yes 1:3,.No DYes ~No 0 Yes ~No 0 Yes ]2i_No 0 Yes j8No 0 Yes ~No DYes ~No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE Phone : 97'2:? -~tt1-:l~ Date: ~,r:?Z/-~/k 21412015 \~~~~~~~~~~~~~ ompliance Inspection Operation Review 0 Structure Evaluation Reason for Visit: ~tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Denied Access Date of Visit: l2=:8S' I Arrival Time:l /~~co Departure Timed ,?: : t>D l County: {;?"~ Region: ff'U Farm Name: --rf'; :p b 'D Owner Email: Owner Name: 4J(kyt ( ~ I Phone: Mailing Address: Physical Address: Facility Contact: ----~----~--n----a-o;------------~----a-r-~----&-,-v-~~~T-.-.t-le-:~~~:~P~•~u~n~~~~r-~~~~~~~~~~--------P-h-o-ne_: ________________________________________ __ Onsite Representative: e.-• Certified Operator: Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts I. Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Application Field a. Was the conveyance man-made? 0 Other: b. Did the discharge reach waters of the State? (If yes, notify DWR) c. What is the estimated volume that reached waters of the State (gallons)? Integrator: ~hlc..c...L....>o:D~------------------------- Certification Number: Certification Number: Longitude: DYes ~No DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No DNA ONE 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page I of3 .. DYes DYes [3No DNA ONE 0-No DNA ONE 21412014 Continued -!Facility Number: I Date of Inspection: z.-?-dl<? ,Sj Waste Collection & Treatment ', 4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes [Zi..No 0 NA D NE 0 Yes D No 0 NA 0 NE .. a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): I cr Observed Freeboard (in): 3 .'2 5. Are there any immediate threats to the integrity of any of the structures o bserved? (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 c losure plan? Structure 5 Structure 6 0 Yes ~No DNA ONE 0 Yes [8 No 0 NA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do an y of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system o ther th an the waste structures require mainte nance or improvement? Waste Application 10 . Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? D-Yes ~No DYes ~o DYes gNo 0 Yes ~No DNA ONE DNA ONE DNA ONE D NA ONE 11. Is there evidence of incorrect land application? If yes, c heck the appropriate box below. 0 Yes ~No DNA D NE D Excessive Ponding D Hydraulic Overl oad D Frozen G ro und 0 H eavy 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 Outs id e of Acce ptable Crop Window 0 Evidence of Wind Drift 0 Appl ic ation O utside of Approved Area 12. Crop Type(s): LofY\ / w/,J /z~~i 13. Soil T y pe(s): ____,Lz±J:..l.....z,_,.B~--------------------------------- 14. Do the receivin g crops(Mfer from those designated in theCA WMP? DYes ~o DNA O NE 15. Does the r eceiving crop and/or land applicatio n site need improvement? 16. Did the facility fail to secure and/or operate p er the irrigation design or wettable acres d etermination? 17. Does the faci lity lack adequate acreage for lan d appli cation? 18 . Is there a lack of properly operating waste appli cati on equipment? Required Records & Documents 19 . Did th e facility fail to have the Certificate of Coverage & Permit r eadi ly available? 20. D oes the facility fail to have all com ponents of th eCA WMP readily avai lable? If yes, check the appr opriate box. Dwup D c hecklists 0 D esign D Maps 0 Lease Agreements 21. Does r ecord keepin g need improvement? If yes, check the appro pri ate box below. D Yes [3No DNA O NE D Yes [Z.No DNA ONE DYes ~No DNA O NE 0 Yes p;!No DNA ONE D Yes Q9-.No DNA O NE D Yes g.No DNA O NE Dother: 0 Yes 18l.No DNA ONE 0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analys is 0 Waste Transfers D Weather Code 0 Ra infall D Stocking D Crop Y ield 0 120 Minute Inspections D Monthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facil ity fail to install and mai ntain a rain gauge? D Yes [251, No 0 NA 0 NE 23.Jf selectcd, did the fac il ity fai l to insta ll and maintain rainbr eakers o n irrigation equipment? DYes C3-No 0 NA 0 NE Page 1 of 3 1/4/2011 Continued .JFacili~ Number: a-'-'711 I Date of lnsl!ectioo: 7-7-.?hJ5i 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes [2iNo D NA O NE i 25. Is the facility out of compliance with permit conditions re lated to sludge? If yes, check DYes ~No DNA ONE • the appropriate box(es) below. 0 Failure to complete annual sludge survey 0Failure to develop a POA for s ludge level s 0 Non-compliant sludge levels in any lagoon List structure(s) and date offust survey indicating non-compliance: 26 . Did the facility fail to provide documentation of an actively certified operator in charge? DYes ~No D NA ONE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? 0 Yes ~No DNA O NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes ~No DNA ONE and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes [gNo DNA O NE permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes , check the appropriate box below. DYes ~No DNA O NE 0 Application Field 0 Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes Qg.No D NA 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? D Yes iii No DNA ONE Reviewer/Inspector Name: Phone : ~p--Krt-33 t:l w Reviewer/Inspector Signature : Date: /-Z -CiJ-?? /.1-' • Page3 of3 11411011 ... IJII!I!IIillllllllflllllllll ompliance Inspection Operation Review 0 Structure Evaluation Reason for Visit: e<outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency Date of Visit : I 2"/j-/f Arrival Time: I / ! VO I Departure Time: I /0 •, 00 I County: .5~?-­Region: Ff?D .. • Farm Name:_:t~r'-...!..: Tf..::;.!..z;r;..,._--.::D=------'N.....::....t~:::...r....,#~y~~----r- \Dal:\. i c-I :J Fa ;r-c)fjf/_ Owner Email : Owner Name: Phone: Mailing Address: PbysicaiAddr~s: ------------------------~---------------------------------------------------------_-:G{_z,;;;....t...p:...n,~~.;:__----'-~-=t;:t'-'-• r._~_J._i6fj__~ Title: ___.,g>w...:;.....;;=--h----'-..,.._v ____ _ Facility Contact: Onsite Repr~entative: Certified Operator: Back-up Operator: Location of Farm: Latitude: Discharg~ and Stream Impacts 1. Is any discharge observed from any part of the operation? Di scharge originated at: D Structure 0 Application Field a. Was the conveyance man-made? D Other: b. Did the discharge reach waters of the State? (If yes , notify DWQ) c . What is the estimated volume that reached waters of the State (ga llons)? Phone: Integrator: /711/ vf lf rtJ ·t.AJ~ Certification Number: / $"I!Jrl~ Certification Number: Longitude: DYes ~0 DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page 1 of3 DYes ®J'lo DYes Di!'lo DNA ONE DNA ONE 2/4/20ll Continued li"acility Number: I nate of Inspection: z-I tl-erOt'H 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: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~o DNA ONE 0 Yes 0 No 0 NA 0 NE Structure 5 Structure 6 0 Yes ~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 improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? 0 Yes l)il_No 0 NA 0 NE DYes (EJ.No 0 NA D NE 0 Yes !29-No 0 NA 0 NE DYes ~No DNA ONE 11. ls there evidence of incorrect land application? If yes, check the appropriate box below. D Yes (gl No DNA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 Jbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): Cor,. /wfz'~,l~s 13. Soil Type(s): ____.k~....,IV;t......::$r:::::..... ________________________________ _ 14. Do the receiving c~Jffer from those designated m the CAWMP? 0 Yes ~No 0 NA 0 NE 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? Page1of3 DYes ~No DNA ONE DYes ~No DNA ONE 0 Yes ~No QYes ~o 0 Yes [&_No DYes l)a.No Oother: 0 Yes [g,No DNA ONE DNA ONE DNA ONE DNA ONE 114/1011 Continued . ~ !Facility Number: f?J-: -lo Z!(l !Date of Inspection: 7-JtJI-· L!::J.I ' . 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE DYes !)iNo DNA ONE 25. Is the facility out of compliance with pennit conditions related to s ludge? If yes, check the appro priate box(es) below. D Failure to complete annual sludge swvey D Failure to develop a POA for sludge levels D Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively cenified operator in charge? DYes ~No DNA ONE 27 . Did the facility fail to secure a phosphorus loss assessments (PLAT) cenification? DYes ~No DNA ONE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 0 Yes b'l No DNA ONE and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? DYes {glNo 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 permit? (i.e., discharge, freeboard problems, over-application) ~0 DNA ONE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Yes ~0 DNA ONE 0 Application Field 0 Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes IM.No DNA ONE 33. Did the Reviewer/Inspector fai l to discuss review/inspection with an on-site representative? DYes ~0 DNA ONE 34. Does the facility require a follow-up visit by the same agency? 0 Yes ~0 DNA ONE C~~nnents (r~fer to question If): Explain any·YES answers and/or any additional recommendations or any{~t~er comm,en~~r':f.-i;~~~;,~ Use drawings of facility to better explain situations (use additionaJ pages as necessary). ) ; · ?'~.; :::~-<~.;_.r:-s~,~\~4 Reviewer/Inspector Name: Phone: 77P--L£P-"3-:.Jc)u Reviewer/In spector Signature : Date: ?-/~~/¥ Page3of3 214/2011 .. 0 Technical Assistance Reason for Visit: ~outine 0 Complaint 0 Other 0 Denied Access I Arrival Time:l'9 ~SOAtf I Departure Time:l9; ~0Aij I County:~ Farm Name: l~:f n Jl.yr.sft* Date of Visit: I talsJo Region: Ff<JJ Owner Name~J){l1LP L ~ rrc&tb Owner Email: ---------------- Phone: Mailing Address: Physical Address: ]qf fi1(rdo1\ r?d RO<fb@ / Phone: Facility Contact: .Donna wircloti> Title: ----'-H ...... fh~'!Yif¥------ Onsite Representative: .OO,oa . to([~ Integrator: ....!H-:....!._.-.~.BO£-_________ _ Certified Operator: Olble I ftJfrc(at~ Certification Number: _.:I:.....~=.=~:;..:S:;._ ____ _ Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? DYes ~No Discharge originated at: D Structure D Application Field D Other: a. Was the conveyance man-made? DYes DNo b. Did the discharge reach waters of the State? (If yes, notify DWQ) 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 DWQ) DYes 0No 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page 1 of3 DYes ~No DYes ~No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 21412011 Continued ' (Facnft)' Number: <fld. I Date of Inspection: to lSI [3 Waste CoUection & Treatment 4. Is storage capacity (structural plus storm storage plu s heavy rainfall) less than adequate? a. If yes , is waste level into the structura l freeboard? Structure I Structure ,2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): JQS: Observed Freeboard (in): 39 5. Are there any immediate threats to the integrity of any of th e structures observed? (i.e., large trees, severe eros ion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? .·. DYes ~o DNA ONE 0 Yes D No D NA 0 NE Structure 5 Structure6 DYes l3No DNA 0 NE D Yes ~No DNA 0 NE If any of questions 4-6 were answered yes, and tbe situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed p its, dry stacks, and/or wet stacks) 9 . Does any part of the waste management system other than the waste struc tures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes 5dNo DYes l8f No DYes ~No 0 Yes [8-No DNA ONE DNA ONE DNA ONE DNA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~No D NA 0 NE' 0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to In corporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. C rop Type(s): Cc/1\:1 )\-l)&b&;b&t [ 13. Soil Type(s): ----L-1-JfS-c/X){dli!~-----"'B[.__ ____________________________ _ DYes ~No DNA ONE 14. Do the receiving crops differ from those designated in the CA WM.P? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irri gation design or wettable acres determination? 17 . Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19 . Did the facility fail to have the Certificate of Coverage & Permit readil y available? 20. Does the fac ility fail to ha ve a ll components of the CA WMP readily available? If yes, check the appropriate box. Owup 0 C heckl ists 0 Design 0 Maps 0 Lease Agreements D Yes ~No D Yes ~No D Yes ~No DYes ~No DYes 181 No DYes 'lSi No DNA O NE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 00ther: ________ _ 2I. Does record keeping need improvement? If yes, check the appropriate box below. D Yes fia No 0 NA 0 NE D 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 I 20 Minute In spections 0 Monthly and 1" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to in stall and maintain a rain gauge? 0 Yes filN o 0 NA 0 NE 23. If se lect ed, did the facility fai l to in s tall and maintain rainbreakers on irrigation eq uipment? 0 Yes 0 No !XNA 0 NE Page2of3 2/4/2011 Continued • " ~ _, !Facility Number: q(;b -(o(~ I Date of lnsl!ection: lai5}1J 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes I>J No DNA ONE 25. Is the facility out of compliance with pennit conditions related to sludge? If yes, check DYes the appropriate box(es) below. ~No DNA ONE 0 Failure to complete annual sludge survey DFailure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. D Application Field 0 Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? Reviewer/Inspector Name: Reviewer/Inspector Signature: Pagel ofl DYes ~No DNA ONE DYes DNo ~NA ONE DYes 8No DNA ONE DYes f8) No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes 181 No DNA ONE Phone: qi(J:!/33-3.300{ofa:~ Date: VUJf_~, ~Q\3 21411011 . :. ~-:: . . . .. :. : r:-;.:.;.fn :J:;-~_t ;: :: .; . FacilitY:.No ~: :~~M ~: ~+~ Na~~ 'Tr 1yte }2 Date ____ _ Permit . · : 1··. COC =~ i , : :: i ; · · · . OIC NPDES (Rainbreaker PLAT Annual Cert · DailyPipe ) -~ -!i','!l ';i!ii[J;I!I!!l:!!--,, I I I ' I f I 'l Tj ·. !• : ~;·~-~:_~:-~~!:.!.~:~; }:~-.·:. . ' . Lagoon Name, s for' spillWay . · 1 2 · 3 4 5 '6 7 · Design ·Freeboard I Last Recorded (in) ',1;'· ; •• 1--R::::a=-=ti=-=·o~S:.:Iu=-=d~jgz.::le:....;to::::..· ..;.T.:,:.re:.:a;.:;:tm:;.;.. ~en~J~!V<:..::o~lu::.:m~· e:..:i:......f>.....:0::...4~5:.__+--"'_-+----+-_:_--+---+---+----f---'-·..;..· .:...j' --- Date out ofcomr:>liarice/POA?-;. .':: - Cal~ration Date;· , ·. > ~: ; 11· ; Ring Size (in) ~ · l.,~c, Des ign Flow (gpm) _-1:\~-(:' · Design Diam ~ (ft) ·' l-1:l'OO :: ,., :: ·. : · Actual Diam.: ' ' · : · trt5 ;_ •: :· W4=~0~~ · ·. ··~1 ii;l .;: :::' Soil ! est Oat~ ).)tz h?: ! ~iji .. pH Ftelds ) ·!boi.l.J_ :_ l i-_ · · LimeNeeded : ~::! · Lime Applied I : : · -:1 i: · · Cu-I · ::/; Zn':..l -~ i ' ! Needs s (S-1~25) . DoTTL i·: ci :: lj:! ::: ':i :: Needs P i ' ' ., Waste Date : lult:J11ii: r bltll \"\ I "I".· -60 Day ! : ~:. l ,;t'l !i.! ! ~ -' -~ : ! ; + 60 Dav I : ~ : ; ! ;;;! ; N (lb/1 000 Gal) M · !: ' l~.n ' .. ' pH ; I ! -'7..11'· I ·' ,,. : 1fn I I ·: . 'I ,, 3 4 Crop Yield Wettable Acres i:7' wu p .:._/;...__,..-.,.- Weekly Freeboard ~ 1 in Inspections .--:-- 120 min Insp. Weather Codes l,jbh"\ tlll8)1) ..... l;):;y ! It"~ "1:1 5 Pull/Field . ! I Soli i ;. : Crop Acres PAN Window i().~ ·~·; !: i : . :! ~ ; ! .. j r ! · ~ i= Verify PHONE N~MB~~~~~laffiliations Date last·VVUP FRo' mmAer~ v 'FRO or Farm Records Date las~ W~p a~ farm/ 1 , • Lagoon # App .. Hardwa~e .-.1 :. : ... ! i': .' . Top Dike ! j ··-r ; , , !· . Stop Pump I 1 I : 1 • ·start P . . . . i :. : :i ! ·:! :. : ump II{. 5' ' ! ! i . . . ! ! : : ! ~ : . . : j : Conversion-Cu-I 3000=! 081b/ac; Zn-13000= 213_1b/ac i : ::; ,:'l i ;:j l.i ·:: :; . I , •• ~·t •lf ;;. I , i . • I • •.. 6 7 Transfer Sheets RAIN GAUGE 8 Dead box or incinerator __ _ Mortality Records Check Lists Storm Water Max Rate MaxAmt · QJ-1 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: '3"Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Region: FJt) Date of Visit: bill I Ia.. I Arrival Time:! \1(00/Vf I Departure Time:lla-;30 P'fl County: 5ih,p FarmName: Tdf/€.. V AJuts:rl OwnerEmail: ------------- Owner Name: Poo)ef FI,Jfrc/Ot-h Phone: Mailing Address: Physical Address: _l.!....CO-=--_RL..:O~tL'rc.:::.;/~..::o....!-f....:JhL__...:..::Y?J~---.JLlR.l6m~e.....::ba~o:::..._ ________________ _ ) Facility Contact: Doooa... fd'l ( c I o-f b Onsite Representative: VOilno..__ FiJfrc/o=t? Certified Operator: full i e I fo Ire loTI) Title: Co:o ~t?-ef DDAOa rnrrdo±b -oo~ w.~"? vaJ., t:nf, c1~ ..... hottn &1Hf-Q;t-V>"7 Back-up Operator: Location of Farm: f Latitude: Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: D Structure 0 Application Field a. Was the conveyance man-made? 0 Other: 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)? Phone: Integrator: .J.H...!..,__,.B'------------ Certification Number: Certification Number: Longitude: DYes ~o DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Pagel of3 DYes !2g No 0 Yes ~0 DNA ONE DNA ONE 214/2011 Continued .. [FacilitY Number: j;r._ JDate of Inspection: 71/J/ ~~< Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed throug h a waste management or closure plan? D Yes rs;a No 0 NA 0 NE D Yes 0 No 0 NA 0 NE Structure 5 Structure 6 0 Yes !).!No D NA 0 NE 0 Yes ~No 0 NA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? 0 Yes ~No 0 NA 0 NE D Yes ~No D NA D NE DYes ~No D NA O N E 0 Yes !&No D NA 0 NE II. Is there evidence of incorrect land application? If yes, check the appropriate box be low . DYes ~No 0 NA 0 NE 0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metal s (Cu, Zn, etc .) 0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Inco rporate Manure/Slud ge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D A p plicatio n Outs ide of A pproved Area 12. crop Type(s): Can 7 hhWJ 0C!Jfbmc • Aycock 13. Soil Type(s): 14. Do the receiving crops di frer from those designated in the CA WM P? 15. Docs the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? Page 2 of3 DYes D Yes D Yes DYes D Ye s DYes 0 Ye s O o ther: DYes ~No IXJ N o ~No ~No rM No ~No Cif"No !E No DNA ONE D N A ONE D N A ONE DNA ONE DNA ONE D NA ONE DNA ONE 214/2011 Continued • IFacni'ty Number: ~")..._ . {o]lf IDateoflns(!ection: ).ltJ.J ld 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes tSa'No D NA O NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes. check DYes ~No DNA O NE the appropriate box(es) below. D Failure to complete annual sludge survey D Failure to develop a POA for sludge lev el s 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? DYes ~No DNA O NE 27. Did the facility fai I to secure a phosphorus loss assessments (PLAT) certification? DYes 0No ~N A O NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes l}g No D NA ONE and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~N o D NA O N E If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notifY the Regional Office of emergency situations as require d by the 0 Yes ~No D NA ONE permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. D Yes ~No D N A ONE D Application Field D Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 0 Yes ~No D NA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 0 Yes ~No D NA ONE 34. Does the facility require a follow-up visit by the same agency? D Yes ~0 D NA ONE Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of3 Facility No. Dcrto I 'I Fann Name _Tj...l...J...lcW~/f.......,t2"------Date J {II l1 d... Permit __ COC __ _ OIC_ NPDES (Rainbreaker PLAT An~ual Cert Daily Pipe) IU1 I I I I I I I I I I I Lagoon Name. S for spillway 1 2 3 Design Freeboard I Last Recorded {in} Observed freeboard ,c;-6 +- Sludge Survey Date Sf~· ...,,. ~'n f10rh Sludge Depth (ft) o/ Liquid Trt. Zone (ft) Ratio Sludge to Treatment Vo lume if> 0.45 Date out of compliance/ POA? ftA tv.*f'/ 1-E> -O.JJ -ll.-e h-; lo/Q/ ~~ Calibration Date 1 ID"R/1() 2 3 4 Ring Size (in) ,·)("' ~" Design Flow (gpm) \;)1 Actual Flow ;:)"0 Design Diam . (ft) jltt) Actual Diam. .lt Soil Test Date ~/to/11 pH Fields ~'' - Lime Needed ___wO~­ Lime Applied Cu-I Vzn-1 t./ Crop Yield ./ Wettable Acres ---:;;;:::r- WUP ~ Weekly Freeboard :?' 1 in Inspections -::;:::;' Needs S (S-1 <25) -;;-120 min Insp. t / Needs P l }-hf) Weather Codes ./ Waste Date l;J I~ QHaWIJ IDI~III ~/to/11 tpfJSIII -60 Day + 60 Dav N (lb/1 000 Gal} I, -I 11 Pull/Field Soil Crop Acres PAN I PI -) lf/Y/"1 1'-fr_ hthl 5Q~v-' "w l3r / Verify PHONE NUMBE.RS and affiliations Date last WUP FRO 11/b)/D / FRO or Farm Records Date last WUP at farm Lagoon# ~P · Hardware Top Dike qq,} ~f;'R, *bf>-J . Stop Pumpl?s ·) C) 0 ~L Start Pum~~b -'1 0 J )q•S" C~~r ion -Cu-I 3000= 1081b/ac; Zn-1 3000= 213 lb/ac 4 5 6 7 . 5 6 7 8 Transfer Sheets IJ /o. RAIN GAUGE Dead box or incinerator __ _ Mortality Records Check Lists Storm Water Window Max Rate MaxAmt WI --- Operation Re\'iew 0 Structure Evaluation Reason for Visit: Routine 0 Complaint 0 Follow-u 0 Referral 0 Emergency 0 Other Date of Visit: R)Sl J 1 1 I Arrival Time: III',Cl?Afj Fa<mName ' ~~: j) hJ:t~ OwnerName: __ \ f"O\rc. __ Mailing Address: Physical Address: 1qf toj'rdo:\11 t?.J) ~O>e. blTO Departure Time:l1a~OO M I County:SPy!Jp, Owner Email: Phone: Phone: Region: fko Facility Contact: Do ooo_ f?a )' rdo:tb Title: _M........:;;.tn-:oa"T"""'fr ____ _ Onsite Represe ntative: DOJ)nll Ril'r c.fotl, Integrator: -'H...~..--..... 8......._ _________ _ Certified Operator: DmLel fa\tJ{!111 Batk-up o.,..,., • ., R®fi l&Jvl:! fynk I JV5) Certification Number: Certification Number: Location of Farm: La titude: Longitude: Discharges and Stream Impacts I . Is any discharge observe d from any part of the operation? 0 Yes ~No Di scharge originated at: 0 Structure 0 Applicat ion Fie ld 0 Other: a. Wa s the conveyance man-made? D Yes 0 No b. Did the di scha rge re ac h waters of th e State? (I f yes , notify DWQ) D Yes 0 No c. What is the estimated vo lume that reached waters of the State (ga ll ons)? d. Does th e discharge bypass t he waste management system? (If yes, no tifY DWQ) D Yes 0 No 2. Is there eviden ce of a pa st disc harge fro m a ny part of the operati on? 3. Were th ere any o bservab le adverse impacts or potential adverse impacts to the waters of th e State othe r than from a di sc harge? Page I of3 D Yes fil No D Yes ~N o DNA ONE DNA ONE D NA O NE D NA ONE D NA ONE D NA ONE 2/412 011 Continued !Facility Number: <f)a., -bJ"{ !Date of Inspection: 91RJ 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 I Structure 2 Structure 3 Structure 4 ldenti tier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 D Yes 1iJ 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 improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improve ment? 8J'Yes 0 No DNA 0 NE 0 Yes ~ No D NA 0 NE DYes ~No DNA ONE 0 Yes C8'No DNA 0 NE II. Is there evidence of in correct land application? If yes, check the appropriate box below. D Yes ~o D NA 0 NE 0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metal s (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lb s . 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of App roved Area 12. Crop Type(s): Cnrl\. hthtt:d StDvbfao { ' J I 13. Soil Type(~: L~~V~C~~~k~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 14. Do the receivin g :fops differ from those designated in the CAWMP? 15 . Does the receiving crop and/or land application site need improvem ent? 16 . Did the facility fail to secure and/or operate per the irrigation desig n or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? lfycs, check the appropriate box. OwuP O c hecklists 0 Design 0 Map s 0 Lease Agreements 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes !)?No DNA ONE DYes [E'No DNA ONE 0 Yes ~No DNA ONE DYes ~N o DNA ONE 0 Yes ~No DNA ONE 0 Yes gNo DNA ONE DYes 18}No DNA ONE Dother: DYes jENo DNA ONE 0 Waste Applicati on D Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers D Weather Code 0 Rainfall D Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and l" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 23. If se lect ed, did the facility fai l to install and maintain rainbreakers on irrigation equipment? Page2of3 0 Yes jRNo 0 NA 0 NE D Yes 0No ~NA ONE 1141201 I Continued .. !Facility Number: '6d--tinlf I nate of Inspection: 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with penn it conditions related to sludge? If yes, check the appropriate box( es) below. DYes ~No DNA ONE ~Yes 0No DNA ONE D Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels ~Non-compliant sludge levels in any lagoon I List structure(s) and date offJISt survey indicating non-compliance: ~ f a±-aso Q$' of: /Q ~/0 26. Did the facility fail provide documentation of an actively certified operator in charge? D Yes ~o 0 NA D NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? D Yes 0 No ~ NA 0 NE 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? DYes ~No DNA ONE 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. DYes IS4;No DNA ONE 30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes ri?No DNA ONE permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below . DYes ~No DNA ONE 0 Application Field 0 Lagoon/Storage Pond 0 Other: ----------------------- 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representati ve? 34. Does the facility require a follow-up visit by the same agency? R eviewer/In spector Name : Reviewer/Inspec tor Si gnature: Page3of3 0 Yes r;ia'No DNA ONE DYes ~0 DNA ONE DYes [8'No DNA ONE Phone : <®--lf-U-32!3 /offl'ce) Date: ~rt q; ;;) 0} J } I 21412011 ( Po/,cfrkn) 1 J Facility No. ~;}-fO'j Farm Name ---+'\r'4¥f-'l ..... f:c..P_--____ Date q I! 1/ Permit ,_,/ COC ~ OIC_ NPDES (Rain breaker PLAT Annual Cert ) Pop. Design Current Type FB Drops " .-.n.w 1-rll ~ iilllll I ., I I I I -...., Lagoon 1 2 Spillway Design freeboard Observed freeboard in) Sludge Survey Date ·J llnJqJtn Sludge Depth (ft) 'J,~· Liquid Trt. Zone (ft) ~6 Ratio Sludge to Treatment Volume (. 160 .'\J ~"i• '[X),~ I Calibration Date 1i(}IQIJ/\ 2 3 4 Design Flow t\{7' ~ Actual Flow '~ l~ Design Width I~ 00 Actual Width _dtfD lH~~ ~' ""i:ffll Soil Test Date I 0 rt/~Dt~ Wettable Acres < pH F1elds Lime Needed _.Q~­ Lime Applied Cu-I ~Zn-1~ NeedsP ~ Cro Yield \7 Pull/Field Soil \ Av5 'd. 3 4 "f '1... Crop Acres PAN (),7 \ 0)' .... -Nr I(J.< \ ~-f'N b'-1 \ ~-\3.> t;-i l I ;;. '-1 I I Verify PHONE NUMBERS and affiliations Date last WUP FRO 11 I'Ji01 Date last WUP rt farm ( '1\ 91 "'\nb FRO or Farm Records lN"1 Lagoon # Top Dike q-~,l f) Stop PumpO)•\ h~ Start Pump q~ rd. J4 fl) 111!1~\.e._ \conversion-Cu-I 3000= 108 lb/ac; Zn-1 3000= 213 lb/ac 3 4 5 6 7 5 6 7 8 RAIN GAUGE Dead box or 1nc1nerator __ _ Mortality Records Window Max Rate MaxAmt NN-_jv) IPS' IJ,.o:;;,_ I 15PO -Ail Dlb.{J-~ t'O u J App. Hardware ' Type of Visit G 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 0 Denied Access DateofVisit: IIDII3IlO I Arriva1Time:f8;ttol4ff I DepartureTime: IJO;mkjl County: 51.h!(ft>1 Region: r~O Farm Name: \c\q\..f n NtxsPrl Owner Email:------------ Owner Name: 'Oaai e\ FnfrdQth Phone: Mailing Address: Physical Address:-------------------------------------~-=-- Facility Contact: D <Oono._ Fqf rc.l~ Title: --"N....:.;D:::....'1~f!J::j...JI.C_____ Phone No: 50)S--~&, Ut) Onsite Representative: Ot>()OL PtJ(rJo-th Integrator: _::....H-..1-... B~---------,----- certified Operator: Do/)j el Fofrdotb Operator Certification Number: ....;f:....q...:....~o~g~~""')"'----- Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Dischllrges & Stream Impacts I -Is a ny di sch arge observed from any part of the operation? D Yes ~N o DNA O NE Di scharge ori g inated at : 0 Structure D Application Fi eld D Oth er a. Was the conveyance man-made? b. Did the di sc harge reach water s o f the State? {If yes, noti fy DWQ ) c. What is the estimated vo lume th a t re ached waters ofthe State (gallon s)? d. Does discharg e bypass the waste manageme nt system? (If yes, no tify DWQ) 2. Is there evidence of a past di s ch a rge from any part of the operat ion? 3. Were the re any adverse impacts or pote ntial adverse imp ac ts to th e Waters of the State othe r than from a di sc harge? Page I of3 DYes D No DNA ONE DYes 0No D NA ONE DYes DNo DNA ONE D Yes ~N o DNA ONE DYes !If No DNA O NE 12!28104 Continued 11 Facility Number:~ 0>,-Gulf Date of Inspection lloln I !O I Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 DYes RNo DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 Identifier:------------------------------------------ Spillway?: Designed Freeboard (in): ) q · > Observed Freeboard (in): -~~5""=----------------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 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 lla-No DNA D NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes SNo DNA ONE DYes ~o DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. D "ves ~No DNA D NE 0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn. etc.) 0 PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area 12. Croptype(s) C.ot~ httz.ea~ Saybew 13. Soil type(s) --L.A~y--JBL.l------------------------------ DYes ~No DNA ONE 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 I:>.J'No DNA ONE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination '! DYes ~No 0 NA 0 NE 17. Does the facility lack adequate acreage for land application? DYes l)l'No DNA ONE 18. Is there a lack of properly operating waste application equipment? DYes gNo DNA ONE • _ ..•.•. · .. -·· .-._ • < to 'qu~stibfif#)~Explain anvYES answers .. ··" ... ,.,. ..... ·. ra~ing~ of facilitftoi~ef!e·i 'txplain sit~ations. (use addit:ioi~al ;j)'ilg~:s··~iS.:IIe~ess•ary Reviewer/Inspector Name Reviewer/Inspector Signature: Date: 12128104 Continued ~ I Facility Number: liJ'd--{i,J:f I Date of Inspection IWfm 1/D I Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check the appropriate box. 0 WUP 0 Checklists 0 Design D Maps D Other DYes ~No DNA ONE DYes ~o DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No DNA D NE D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers D Annual Certification D Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Did the facility fail to conduct a sludge survey as required by the permit? 26. Did the facility fail to have an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? Other Issues 28. Were any additional problems noted which cause non-compliance of the 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? Page 3 of 3 DYes l}lNo DNA ONE DYes 0No ~NA ONE DYes ~No DNA ONE DYes 18JNo DNA ONE DYes uaNo DNA ONE DYes DNo ~NA ONE DYes 18]No DNA ONE DYes 1&1No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes f29'No DNA ONE DYes ~No DNA ONE 12/18/04 • Facility No .~f.e 7'1 Farm Name _-.,........:L)r--'~'~rff-L-If>........&oO!:(} ____ Date lOh3{ IQ Permit COC OIC_ NPDES (Rainbreaker PLAT Annual Cert ) Pop. Design Current Type :JfaiiO FB I I I I LaQoon 1 2 3 4 5 6 7 Spillway Desiqn freeboard ObseNed freeboard in) Sludge SuNey Date lt~lj Sludge Depth (ft) ~,0 Liquid Trt. Zone (ft) -;},(o Ratio Sludqe to Treatment Volume O,Llq dlv.tlrhJI Calibration Date 1 S 1~:) Iff' 2 3 4 5 6 7 8 DesiQn Flow }3)... Actual Flow \'\") Desiqn Width ~0 Actual Width d'it- t'by:t of~~ ,~ 'M 'l.) ~ '() 1-e S'ne 0'1 wt Wettable Acres _,..._...-....::....___ RAIN GAUGE WUP , ./ Dead box or incinerator __ _ Weekly Freeboard ~ Mortality Records 1 in Inspections \,/"'" 120 min Insp. '-"'"""' Weather Codes __... Transfer Sheets Pull/Field Soil Crop Acres PAN Window Max Rate MaxAmt 1--'l" A,R ('.~~," /\..I f) )'+r O_L<> n,"'-' I WhM-Sor-. '!i""O ~spl' ~m\1 s~" 13~\ _)_'}] \ w~ % ~ Q--r J_ < ~0~ 70\{l"t==l4t1 ., Q J Verify PHONE NUMBERS and affiliations Date last WUP FRO Date last WUP at farm H--{)j-Dj App. Hardware FRO or Farm Records Lagoon# Top Dike Stop Pump Start Pump Conversion-Cu-I 3000= 108 lb/ac; Zn-1 3000= 213 lb/ac -o ' • Type of Visit ~Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit QRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: h;) HftJ f I ArrivaiTime:l q; IYA;+fJ Departure Time: I I D ;Jtj HJJ County: 5fh(flh Form Nam" Tf j f (-e._ 1) 'fl/1/'15~7 Owner Email' ------------ Owner Name: l)Oilitl q.-J: 00nt'l.O--FtifrdaPJ Phone: Mailing Address: ---------------------------------------- Physical Address:---------------------------------------- Facility Contact: OQnnL PtJ{rcfo-h, Title: CD-:Ovrltt Phone No:tl~ JI~-40f17 Onsite Representative: \)onn4 @irJo-f!l Integrator: Hvlply-8/0tfln· Certified Operator: .{) Oa if I Ea\'r c lo:f:J) Operator Certification Number: AwA I 9'8 ~r Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts l. Is any discharge observed from any part of the operation? 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 of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? DYes 0No DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE DYes ~No DNA ONE DYes WNo DNA ONE 12128/04 Continued 'j Facility Number: <{;)..._-~~f.{ I Date oflnspection I QH/B y I Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes f)lNo DNA D NE DYes 0No DNA ONE Structure 5 Structure 6 Identifier:------------------------------------------ Spillway?: Designed Freeboard (in): ) q,.) Observed Freeboard (in): .....loj~~~~-------------------------------------- 5. Are there any immediate threats to the integrity of any of the strucrures observed? (ie/large trees, severe erosion, seepage, etc.) DYes 15a'No DNA ONE 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~o DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any ofthe structures need maintenance or improvement? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ~No DNA ONE DYes ~No DNA ONE DYes ~o DNA ONE DYes ~No DNA ONE 11. Is there evidence of incorrect application? If yes, check the appropriate box below . 0 Yes Oi(No DNA D NE 0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12. Crop type(s) Call. Whe:": So, be(J? l 7 ~ I 13. Soil type(s) ....~.A'.:JJJ.y-"B~s'....J.j...l/ ___________________________ _ 14. Do the receiving crops differ from those designated in the CA WM P? D Ye s ~o 0 NA 0 NE 15. Does the receiving crop and/or land application site need improvement? DYes IS"No DNA 0 NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? D Yes ti No 0 NA D 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 Reliewer/lnspector Signature: DYes "ba'No 0 NA D NE DYes 1)lNo DNA ONE 11128104 Continued I Facility Number: s~ -G,J11 Date of Inspection IWi'tfOfl Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Pennit 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 Checklist~ D Design D Maps D Other DYes ~No DNA ONE DYes ll{No 0 NA D NE 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes i)dNo 0 NA D NE D Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification. 0 RainfaU 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? . 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Did the facility fail to conduct a sludge survey as required by the permit? 26. Did the facility fail to have an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? Other Issues DYes DYes DYes DYes DYes DYes ~No · DNA ONE 0No fiaNA ONE ~No DNA ONE 9No DNA ONE j'JNo DNA ONE 0No ~NA ONE 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~0 DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? 30. At the time ofthe inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately 31 . Did the facility fail to notify the regional office of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 33. Does facility require a follow-up visit by same agency? DYes DYes DYes DYes DYes if'No DNA ONE ~No DNA ONE 18'No DNA ONE D(No DNA ONE il("No DNA ONE "'.· .. ~ ~ ~ " ~"~-... :":_:"' .. ~ ~ . . L~atn hor jOOtL CIJVfr bat '(Yitfe '* t+ i.s wedJ-htU) o~l. r ~ Ple8de.-do ~00~. Slv,_1J~c Svrvey h~ flld of-year. w,lln-eerf+o . f""~ f ovt-sl v~ j'h~,.rsr.:~e. Mtfo Y'faefrv s-0 Of 0 .{ w M t.jb,~1o /() ooo~). {)vt-qfl welt malhia~J. --f1ttm q !JocrL record.s, l&f--ftrm ltr Back~f 0/C' 12118104 • Facility No. f>J=G,1 '1 Farm Name ]ffp(-e_ _{) Date _____ _ Permit ___ COC ___ _ OIC_ NPDES (Rain breaker PLAT Annual Cert } Pop. Design Current Type ~~~ops I I I Lagoon Spillway Design freeboard Observed freeboard in Sludge Survey Date c Sludge Depth (ft) Liquid Trt. Zone (ft) Ratio Sludge to Treatment Volume Calibration Date 1~1~ 2 Design Flow ~~ (1 Actual Flow 1 b. Design Width J10 Actual Width .:'li.tr -., Soil Test Date t.da~flo q pHFields ~ Lime Needed O Lime Applied Cu-I /zn-1 L__ Needs P ~0~--- Cro Yield ...,.- Pull/Field Soil Crop 1-<r Cn•lt J t.. i r ,.,l[ljl ~f \vh8if- "1"'11.,. TOll r 1 2 -" (' altqJ 1/JI ) !\,"""'i ~ :::>.1j ,'1~5 3 4 Wettable Acres v',. ~ WUP \./"" _ Weekly Freeboard ~ 1 in Inspections -~~- 120 min Insp. V Weather Codes ::;;:o>" Acres PAN AfO f"tr j"() l.tr q~ ....,#\ Verify PHONE NUMBE;RS and affili9tiqns Date last WUP FRO-ttl'rior ~ </(fu(~ate last WUP at farm FRO or Farm Records~ Lagoon# Top Dike qq.\ Stop Pump ~ Start Pump • Conversion-Cu-0= 108 lb/ac; Zn-1 3000= 213 lb/ac 3 I I I I 4 5 6 7 5 6 7 8 RAIN GAUGE Dead box or incinerator __ _ Mortality Records Window Max Rate MaxAmt ~~"' -"~AA ,r \Wt~~ r[ I y , Q So v�, Beaf� !f�� +0ems / ild ak R I� o G o y t- � Q 1R gR aL- 29-- Q 1 L lig � w Uk 13L D� outh River Ut -ISR ·. ~!MJ' Type of Visit ():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 Date of Visit: I J~l~IOB I Arrival Time : 11; ISAH I Departure Time: h&l ls-Att I County: 5oh.fSt/t Region: f120 Farm Name: Y[pk l) A/tN'J(/'y Owner Email: ------------ Owner Name: fttl ie) \OM!a ( Fa !rdatb Phone: Mailing Address: ---------------------------------------- Physical Address:---------------------------------------- Facility C ontact: J)OQD(L_ Filtfcftr/1, Title: -:O~.,~".LJ~"-------- Onsite Representative: ...,l)..,.Q,....ooL.AI.6a.______.R:z........, .... ~'-'C;:;..;l:.::;D_i;i~------ Phone No: al't:LJOBJ Integrator: HVtro/. f='.trti ~ Ft?r /)I { Operator Certification Number: AwA l'f8J L Certified Operator: ~if \ $' Ftu'rdot f) Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts I . Is any discharge observe d from any part of the operation? DYes t)tNo DNA ONE Di scharge ori ginated at: D Structure D Application Field D Other a. Was the conveyance man-made? b. Did the di sc harge reach waters of the State? (If yes, notifY DWQ) c . What is the estimated vo lume that reached waters of the State (gallons)? d. Does disc harge bypass the waste management system? (If yes, noti fy DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse imp ac ts or potential adverse impacts to the Waters o f the State o th er th a n from a dis charge? Page 1 of 3 DYes 0No DNA ONE DYes DNo DNA O NE I DYes 0 No DNA O NE D Yes tiZ] No DNA ONE D Yes rB""No DNA O NE 12128104 Continued I Facility Number: 'b~ -((nlf Date of Ins pection Ud,IQ fQi' I Waste CoUection & Treatment 4. Is storage capacity (structural plus storm storage plus he avy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes fi{No DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 Identifier:-------------------------------.------------ ~· Spillway?: ------------------------------------ Designed Freeboard (in): ....LI..Jjq,t....:S""~---------------------------------- Observed Freeboard (in): _3.;;;...!:.0 ____ ------------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) DYes D{No DNA ONE 6. Are there stru ctures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes !»No DNA ONE If any of questions 4.{; 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 pennit? (Not applicable to roofed pits , dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks , or compliance alternatives that need maintenance/improvement? DYes jgNo DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes [8No DNA ONE I I. Is there evidence of incorrect application? If yes, che ck the appropriate box below. 0 Yes CiNo DNA D N E 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 Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12 . Crop type(s) Carll }vhfni ..5oybeo» :J " I 13 . Soil type(s) ..:.A~y~S"--..:s:::..urJL-------------------------- 14. Do the receiving crops differ from those designated in theCA WMP? I 5. Does the receiving crop and/or land a ppli cation site need improvement? DYes 18"No DYes QiNo 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination?D Yes (ljNo I 7. Does the facility Jack adequate acreage for land application? 18 . Is there a lack of properly operating waste application equipment? Reviewer/Inspector Name Reviewer/Inspector Sig nat ure: Pagel of 3 DYes ~No DYes ~o 12128104 DNA ONE DNA ONE DNA ONE DNA ON E DNA ONE Continued j Facility Number:cna.. Jplt( j Date of Inspection I J)IQ ffl Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other 0 Yes af-No 0 NA 0 NE DYes ~No DNA ONE 21. Does record keeping need improvement? Ifyes, check the appropriate box below. DYes ~No 0 NA D NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Annual Certification 0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Did the facility fail to conduct a sludge survey as required by the permit? 26. Did the facility fail to have an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? 30. At the time of th e in spection 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 wi th an on-site representative? 33. Does fa cility require a follow-up visit by sa me agency? ., . DYes l}l-No DNA ONE DYes 0No !)aNA ONE DYes 'til No DNA ONE DYes ~No DNA ONE DYes IS No DNA ONE DYes 0No ~)iNA ONE DYes SiNo DNA ONE DYes IE"No DNA ONE DYes 18"No DNA ONE DYes 18No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE ..... I--Ia, W~etrl-el4ttftL Ql,~ ;t weei{.t '!JO· as. Stvt!Je. c.f.e"ovt-'Mr ~revr·~z ~'tlt~~tvill ~~£/bJ:~ ~:;;,,, nev J"'ldeiD-!-e-t Slvdje_ llerh'-1/h 0 t}t'~vbl..-,e. ~ I wen maMan,eL f0fh1Cl-rerrYd.s} Page3 of 3 12128104 . . .r/ / Date I d. h~.l Dl Facility No. ~6:>7'{ Fann Name Jr,fl~ D Wry Permtt COC v' OIC_ NPDES (Rainbreaker PLAT Annual Cert ) Pop. Type Design Current rB Drops I I _____ I Lagoon Spillway Desion freeboard Observed freeboard (in Sludge Survey Date ~l,qtm Sludge Depth (ft) & % Liquid Trt. Zone (ft} &~ -4 Calibration Date 1q'tl~llJ' 2 Desiqn Flow 13;:). Actual Flow l:b Design Width ~"'X> Actual Width ; 'IS"" Soil Test Date 'fbtfOl~ pH Ftelds i&..p_ Lime Needed ..::q;t__ Lime Applied Cu .._/zn :/ Needs P 0 Pull/Field Soil ··-- Crop I ~C/o11 wfl' . ·~ • ...,. rA •• ( !:' j,;y ,_,,.,/. ... ..&. 1 2 3 -~ :J,'I ;),....,, ''f~ 3 4 Crop Yteld ~ Wettable Acres / WUP / Weekly Freeboard jf! Rainfall >1" · RYE PAN -"70 ft-N'1 CfOt-9-J 'Y. c.r Verify PHONE NUMBERS and affiliations / Date last WLiJP FRO \(\4)-0c.;--Date last WUP at farm If 0 f FRO or Farm Records Lagoon# ' Top Dike qq,) Stop Pump ~·\ --~ Start Pump <\w·" ~">' 4 5 Window 5 6 6 7 1 in Inspections 120 mtn Inspections Weather Codes Transfer Sheets RAIN GAUGE Max Rate .. NI: J!!'-~ I ..... ~ _A~_, I"JL ~~~ -,IJ'If J3s-~~S'~T ll.u.. (", , ~'Y 0 ' App. Hardware 7 8 _..,... ----......--1 nTIL Max Amt --- • $"Division of Water Quality I Facility Number I.'B~ H II ~7'1. 0 Division of Soil and Water Conservation 0 Other Agency Type of Visit @Compliance Inspection 0 Operation Review 0 Structure Evaluation () Technical Assistance Reason for Visit "@ Routi ne 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: 11~;)3=-071 Arrh·al Timed OJ ;oo PH I Departure Timed()C);OOP 111 County: QJ,f'h Region: F'<O Farm Name' :~ n ~ Owner Name: =~ Sc ; Owner Email: ------------- Phone: Mailing Address: 401 P/'fd,o;f-1/IIIW Pd Physical Address:---------------------------------=--------- Facility Contact: A>oM,.JtJi\doi!) Title: Phone No(_qrp)~'l:t'l1 fc.) Onsite Representative: ------------------Integrator:---------------- Certified Operator: lU,je\ S. @!'rclo±b ----------Operator Certification Number: )q8J.) Back-up Operator: t)QM4 ~frc(flf'1l Back-up Certification Number: ~~~ ~ Location of Farm: D OD'D" DOD'D " Latitude: Longitude: Design Current Design Current Design Current Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population ID Wean to Fini sh I I ~W ean to Fe eder QMO ~~3 D Feeder to Finish D Farrow to Wean D Farrow to Feeder D Farrow to Finish 0 Gilts 0 Boars ---·-- 0 Dairy Cow I D Dairy Ca lf I D Dai_ry Heife1 i D Dry Co w ! D Non-Dairy D Beef Stocker I 0 Beef Feeder I 0 Beef Brood Cow I -·--·----· 10 Layer 0 Non-Layei Dry Poultry D Layers D Non-Layers D Pullets 0Turkeys Other ID Other 0 Turkey Poults 0 Other Number of Structures: [.lJ Discharges & Stream Impacts I . Is any di scharge observed from any part of th e operation? DYes RNo DNA ONE Discharge originated at: 0 Structure D Application Field D Other a. Wa s the conveya nc e 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 th e estimat ed volume that rea ched waters of the State (gallons)? d . Does di scharge bypass th e waste management system ? (If yes, notify DWQ) 2. Is there evidenc e of a past discharge from an y part of the operation? 3. Were the re any adve rse impa cts or potenti a l adverse impacts to the Waters of the State other than from a dis charge? DYes ~0 DYes l»No DYes t(No 12128104 DNA ONE DNA ONE D N A ON E Continued I Fa~ility Number: ~d-.-fzl~ J Date of Inspection II~ f;)t l;y:of7 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 0 Yes t)lNo 0 NA D NE DYes 0No DNA ONE Structure 5 Structure6 Identifier:----------------------------------------- Spillway?: Designed Fre eboard (in): ---Ll.....:'l::....:'Y:::._ ___ ------------------------------ ObscrvedFreeboard(in):__.,3LJ...L---------------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? DYes 18'No 0 NA 0 NE (ic/large trees, severe erosion , seepage, etc.) 6 . Are there structures on-site which are not properly addressed and/or mana ge d 0 Yes "'No 0 NA 0 NE through a waste management or closure plan ? If any of questions 4~6 were answered yes , and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structure s need maintenance o r improvement? 8. Do any of the stuctures lack adequate markers as required by the penn it ? (Not applicable to roofed pits, dry stacks and/or wet stac ks) 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, o r compliance alternatives that need maintenance/improvement? DYes !SlNo DNA ONE 0 Yes i8'No 0 NA 0 NE DYes 18'No 0 NA D NE DYe s ~No DNA ONE II. Is there e vidence of incorre ct applic ati o n? If yes, check the appropriate box below . 0 Yes !if No 0 NA 0 NE 0 Excessive Ponding 0 Hydrauli c Overload 0 Frozen Ground 0 Hea vy Meta ls (C u, Zn, etc.) 0 PAN D PAN > 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outs ide of Acceptable C rop Window 0 Evidence of Wind Drift 0 Application Outside o f Area 12 . Crop type(s) Ccrn,tvhen±-Sovbea., C , I 13. Soil typc(s) ..!.Ay~J.l~~·-------------------------------- 14 . Do the re cei ving crops differ from thos e designated in the CAWMP ? 0 Yes ~No 15 . Does the receiving crop and/or land app lication site need improvement? 0 Yes ~No 16 . Did the facili ty fail to secure and/or op erate per the irrigation design or wettable acre detennination?O Yes IE" No 17. Does the facility lack adequate a cre age for land application? 18. Is there a lack of properl y operating waste applic ation equipment? DYes Q!No DYes ~No Comments (refer to question #): Explain any YES answers and/or any recommendations or any other commen!s· Use drawings of facility to better explain situations. (use additional pages as necessary): DNA DNA DNA DNA DNA Reviewer/Inspector Name JO/Jit Sr.Jt n-tl fr Phone: (CfJo) 4~~-3300 Reviewer/Inspector Sig nature: ~ 11.., 4. ..I ..I i'.A.. -1~ lat ItO; ~ Date: ONE ONE ONE ONE ONE ..... 1- 1-.. v 1212 8104 Continued ~ . . , I Facility Number:~~ -t!lL( I Date oflnspection IQju 10') I Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Pennit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropirate box. 0 WIW D Checkli sts 0 De sign 0 Maps 0 Other DYes 5aNo DNA ONE 0 Yes ISl'No DNA 0 NE 21. Does record keeping need improvement? If yes, check the appropriate box below. !Sl'Yes D No DNA 0 NE D Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers D Annual Certification D Rainfall [X"Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and 1" Rain Inspections 0 Weather Code 22 . Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rainbrcakcrs 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 los s asse ssment (PLAT) certification? Other Issues 28. Were any additional problems noted which ca use 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 pos e 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 Pennit? (ie/ discharge , freeboard problems, over application) 32 . Did Reviewer/Inspector fail to disc uss revi e w/in spection with an on-site representative? 3 3. Does facility require a follow-up visit by sam e agency? Additional Comments and/or Drawings: DYes fiaNo DNA DYes DNo ~NA DYes rslNo DNA DYes SNo DNA DYes Iii No DNA DYes DNo i)JNA DYes !XNo DNA DYes ~No DNA DYes ~No DNA DYes IX' No DNA DYes il§'No DNA DYes ·til" No DNA ~l. P1-f6Je... l<'t'tf recn-ds o-f-s~\-e..rlocJc~tvf~ 611fr retCY~ (trtih(A&W~ (;'lt€m~17) ~y. ~tm Slo~e_ rvr:~ tvQ j ScAf'dvl-tt{ f«-Dec-Pn ~ Wb\--uv-t I.P.d~ ~yei--. ~tlo 11\ lrth~j t+ notdo.-e. y-e"T. Slll~e.-io be-fv'"fel ovf-bl ;tOO~ crl-1J.e 1akrl-. I' Calf br8flt-o, of-!Jvtt it> be dO?e_ II\ c}.OOB, Well m~lda~J... -{Wnt1 3ooJ recr;yrJ~. Mf~ nme f~ ~~~il~K-~ &t~ f,o., eoor.~ £~en t.a/leJ. aJ. evfloNtifltdf- S»Ye. ~e -tnr~ hod wr"eJ...;" "'-f~) hPs ~ 3\v.er, vtrl) 111le. emJ uf-~e t~ Nclcl-e h dOO, to re"'o....,e.,slv~~ cwL has aJhallow l~oo, J-h~ -ftlcll~ i.s &-emf#-f,rmslvt/Je- 5vrvep vlftl \ c leQI1ov\-, 12/18104 ONE ONE ONE ONE ONE ONE ONE ONE ONE ONE ONE ONE -~ ... . e Division of Water Quality ·1 Facility Number j ~~ H __ 6~'/ II ::: 0 Division of Soil and Water Conservation :;::_!\ ~--·--·----0 Other Agency Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency Date of Visit: !1 ~ -R-(),6 I Arrinl Time:! D8: tft'ttml Farm Name: fr•'pl €. p, ~ ~Sey-y Owner Name: J)Qn i -e I Fru r d ofb Departure Time: I oq ,'y(al"\1 County: 0 Other 0 Denied Access Region: rR.tJ Physical Address: ----------r---,------------------:......__'----------____ _ _ ....,D'-'o:.....:....ln._'1....__0t..__...JF"a;.__.:;_'_r....:::d:....a..o<{fjb-=---=---Title: ----------Phone No: --------Facility Contact: 1 I Onsite Representative: ------------------Integrat or: fV1 u,y f~ Certified Operator:--------------------Ope rator Certification Number: ------- Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD 'D " Longitude: Wet Poultry . D,esign Current C~p~City Population Swine ·. Design Current Capacity Population D Wean to Finish 00 Wean to F ceder :lbOO ,.580 10 Layer 0 Non-Layer ] Feeder to Finish 0 Farrow to Wean 0 Farrow to Feeder 0 Farrow to Finish D Gilts D Boars . --· ·------ Dry Poultry D Layers 0 Non-Layers 0 Pullets ' 0 Turkeys D Turkey Poults 0 Other ·--· Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? DYes ~N o D NA O N E Discharge originated at: 0 Structure 0 Application Field 0 Othe r 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 (g all ons)? d. Does discharge bypass the waste management system? (If ye s, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Page 1 of3 DYes D No fi)NA O NE DYes 0 N o ~NA O N E I D Yes 0 No e9N A O NE DYes fBN o D N A O N E DYes ~N o DNA O NE 12128104 Continued Date of Inspection ltJ-t.J:-oJ2 I Waste Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes ~No DNA ONE DYes 0No ~NA ONE Structure 5 Structure 6 Identifier:---'-'-------------------------------------- Spillway?: Designed Freeboard (in): ----.,....-------------------------------------•"'1 , ,, Observed Freeboard (in): --~tll-_..;;;.tr ___ -------------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) DYes f1J No DNA ONE 6. Are there structures on-site which are not properly addressed and/or managed DYes E7J'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 ofthe stuctures lack adequate markers as required by the penn it? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks. or compliance alternatives that need maintenance/improvement? 0 Yes ~No DNA ONE DYes E;pNo DNA ONE DYes ~No DNA ONE DYes qJNo DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE D 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 D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area 12. Croptype(s) --:-C-=-:..~...;,..,:,Jh~1 uJL,gf-~::::::.:::li:4-f _.S~~~beat..LL~J..nu.S __________________ _ 13. Soil type(s) ~ 6 14. Do the receiving crops differ from those designated in theCA WMP? DYes ~No DNA ONE 15. Does the receiving crop and/or land application site need improvement? DYes ~No DNA ONE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes ~NoD N~ 0 NE 17. Does the facility lack adequate acreage for land application? DYes ~No DNA ONE 18. Is there a lack of properly operating waste application equipment? DYes ~No DNA ONE ComiiDeJJts_(r_e~fer· to questiort#):. Explain any YES answers and/or facility to _bet;ter explain situ~tions. (use additional Reviewer/Inspector Name Reviewer/1 nspector Date: Page2of3 11128104 Continued -· I Facility Number: s~ -6741 Date of Inspection I/~ -IJ ~~ Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. D WUP D Checklists 0 Design 0 Maps 0 Other 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No DNA ONE DYes ~No DNA ONE DYes lflNo DNA ONE D Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers D Annual Certification 0 Rainfall D Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and I" Rain Inspections D Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes 0No t::jl 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 ~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 DNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? DYes ~No DNA ONE 30. At the time of the inspection did the facility pose an odor or air quality concern? DYes fFJNo DNA ONE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notifY the regional oftice of emergency situations as required by DYes 00No DNA ONE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE 33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE Page3 of3 12/28/04 ... _·, e Division ofWater Quality 0 Division of Soil and"·" ... lt .... --. r't1rn ... pnrJitiinn 0 q¥~r -~gen~f ' I:FaciiityNumber I$,? -~ /,7~ II Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access Date uf Visit: I (, · /t ·t>) I Arrival Time: I 'f:Jtf" Departure Time: ._I ___ __.I County: 5a~ Region: f1f.-'-'-o __ _ FarmName: --~jj~r~·~~~~~~~----~P~--~~~v~'~lue2~~v~------------------Owner Email: ------------------------/ Owner N arne: __ .o;;/}.;..ot2.......,n"-:"-t:.,_{ ____ _,(!ff,=>"Joa_ ___ ..={):;...t?~il7n,...,4!~.--_...:F....!ec.s..Lirc.r.to../.u.z~M~---Phone: Cflo-~:J s= -'t:l ::J{, Mailing Address: _lj..,.o"'-"1 __ .:...f.LJZta~s"a::~:.,Lf __ ...::(/;..,I)ULC''a;;r.!.,:L-_~£L.!J:L-__ ___;~Zll!::r;__r_llua6ru:'t!a.j,u4u.r.£J.I'J'-JJ'-'N~C.~--:2 238--2. Physical Address: ----------------------------------------------------------- Facility Contact: _ __,O=-"oo.:;n.cl2:.wA.....___.6'-"a..._::.<.,'r. .... G ..... k~t,_,h'-'----Title: ------------Phone No: ___________ _ Onsite Representative: __ /J__,a..,,""'b""'« _______ _,£,_..-:;.._, ... ·c~e"'"'l ..... .,'-S-.JI,LI-------Integrator: /Yiv~f/..l-&ro .. ,, Certified Operator: ------:.D::.ea"""'-Cou·--"'· e.i<-1/'---__ f-.-=a=-:,..._..c.=J.=~',_#,~-------Operator Certification Number: I 91J:!C Back-up Operator: ----------------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: D OD'D" Design Current Design Current Design Current Swine Capacity Population Wet Poultry C~pacity Population Cattle Capacity Population r.:ID::::;--W-e_a_n -to-F-in-i-sh-,1..----,----'------.,1[10 Layer I I 1:. ~-D~N_o~n~-~La~y~e~'--~-~~~~-~~~~-~can to Feeder ~~00 :Jl,;l.O I 0 Feeder to Finish 0 Farrow to Wean ' 0 Farrow to F ceder 0 Farrow to Finish 0Gilts ! ! ; D Boars I -... ----·•-·r D Dairy Cow ' D Dairy Calf ' D Dagy Heife1 I I D Dry Cow ! D Non-Dairr I D Beef Stocke• I D Beef Feeder ! D Beef Brood Cow i I ·-·-.. --~ Dry Poultry 0 L1:1ycrs 0 Non-Lavers 0 Pullets 0 Turkeys Other 0 Turkey Poults 0 Other --.. IQ C?ther Number of Structures: CLJ: Discharges & Stream Impacts I. Is any discharge observed from any part of the operation? DYes IY-No 0 NA D NE Discharge originated at: D Structure 0 Application Field D Other a. Was the conveyance man-made? DYes 0No DNA ONE b. Did the discharge reach waters of the State? (If yes. notify DWQ) DYes 0No DNA ONE c. What is the estimated volume that reached waters of the State (gallons)? d. Docs discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge lrom any pan ofthe operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? DYes 0No DYes ~0 DYes GI1'Jo 12118104 DNA ONE DNA ONE DNA ONE Continued I Facility Number: $.l -(, '1'{ Date of Inspection I(, -{&,~or I Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? DYes ld1'io DNA D NE DYes 0No DNA ONE Structure !- Identifier:--·--·-"/~----------------------------------- Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Spillway?: '10 ~ Designed Freeboard (in): __ -;_j.-/"-o/.LJ,t..oL:__"_' _ --------------------------------- Observed Freeboard (in): _ ___...~=->(,""--,.--,_---------------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? DYes (ie/ large trees, severe erosion, seepage, etc.) [3-No DNA ONE 6. Are there structures on-site which are not properly addressed and/or managed DYes ld'No DNA ONE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improv ement? DYes ~o DNA ONE DYes ~o DNA ONE DYes ~o DNA ONE DYes ~o DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ta"No 0 NA D NE 0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN > 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area 14S'" s-ojt:t'f 13r 12. Crop type(s) C()ra LJ4,,.f Soylu:.~ru 13 . Soil type(s) 14. Do the receiving crops differ from those designated in theCA WMP? DYes !a"No DNA 15. Does the receiving crop and/or land application site need improvement? DYes B1'/o DNA 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination! 0 Yes DNo DNA 17. Does the facility lack adequate acreage for land application? DYes 0No DNA 18 . Is there a lack of properly operating waste application equipment? DYes ~0 DNA ONE ONE [31ii'E [31ffi ONE Reviewer/Inspector Name Reviewer/Inspector Signature: Phone: Cflo-W(,-g'f/M?]D Date: (,·II, -OS 11118104 Continued • I L •• I Facility Number: 8;? -{,?If Date of Inspection It -1~-ti"J Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? DYes ~DNA ONE 20. Does the facility fail to have all components ofthe CAWMP readily available? Ifyes, check DYes ~ DNA 0 NE the appropirate box. 0 ~ D Chec~ 0 ~ D ~ ~ Does record keeping need improvement? If yes, check the appropriate box below. ~s D No 0 NA D NE 't-ff"•7 ;l.([ .).,~.,,.~ ,-10-) /.3 21. 0 Wast8 Aflj'!lieetiaHo J GlW'eekly Freeboard 0 Waste 1'tnalysis 0 -B'eil AAalysis-0 W8£i~e Tl:aAsf8rs 0 ARRwal Ci!Ftifieation ~infall 0 Stocking D Crop Yield 0 +JO Mjnnte J.aspections ~onthly and 1" Rain Inspections D Weat~er Cgde 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Did the facility fail to conduct a sludge survey as required by the permit? 26. Did the facility fail to have an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than 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? ;J.J, fJ ,.,J.,r~r ,'_$ &~'I"·~~ .,.:,...,.., .. ,../ ~~~e/.5 t;~r/ ra/,. Fed/ re~t:IP'Js f~r, Pl~a~ s-k,f "J··,~ a,. ~11'"-'/ F,,..,, f'Jt~t!tt.S~ D Yes G;;Hq'o 0 NA 0 NE DYes 0No DNA Q.NE DYes 0No DNA ~E DYes DNo DNA G:HfE DYes ~DNA ONE DYes 0No DNA GJ.M1: DYes (3-jqo DNA ONE DYes ~0 DNA ONE DYes G3"No DNA ONE DYes 1:3"f.lo DNA ONE DYes B'No DNA ONE DYes lErNo DNA ONE ,, no'-4,4- ;,,·/../ F~r "' ,., /1, 7 CI,J /r' /j 1 ,', Sf'e/,'"" $, It v. 't! ru~J 7,'~/,/ lt'l'f4. ~,., CrflfJ ..... 1;,-,.s. 12128104 Type of Visit 8 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation Reason for Visit 8 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other D Denied Access I Date of Visit: 12 • ;llf ·6'11 Time: I ·/I.' <16 I Facility Number I 8 .2 H ~ 79 · · '---------------------J lo Not Operational 0 Below Threshold m Permitted r.\11 Certified C Conditionally Certified C R....io:tered D t L t 0p ted Abo -r&.---L ld IIIII tu --a e as era or ve 1.un:~uo : ----·--· Farm Name: ........ TL.".' .. f?Js:.-......... ~ .......... ti~'t...L~~---·-·--··--····-·-County: ...... 2 ... !!~-fl~4.b. ...... ---.... E.O.SL. Owner Name: ....... Q ... ~.~~-~-L.l ................ O.~ .. n..a..~ .. --.J:.~.; ... ~.~J.!?.±'.~... Phone No: ... {~--~~-J.-.... ~~-~.:. .... ~'!l.til.£. ......... . Mailing Address: ............... ~{?...!.. ....... f.!.!.~.~.s.e..ct ... t .......... lL~Y..t~.a ...... fv.. ................. ~'!..J .. r:::~~-r..e .. -; .. ..N. ... C............ .!fl!..'-.f..~ .. Facility Contact: .............................................................................. Title: ................................................................ Phone No: ---------------·· Onsite Representative: ............. Q..!..~~ .. !':.. .......... .£c...:.~ll.1:.h ... _............. Integrator: -·-·-----·--·-------------- Certified Operator: ......... D. ..... .J::\.~,..c..\.. ................ ..F..A.~~r . .&....i.O::h................... Operator Certification Number: -~..J..~j_~-- Location of Fann: Ill Swine D Poultry D Cattle D Horse Latitude ,__ _ _.1• ._I _ _.I' ._I _ ___.I" Longitude Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Discharges & Stream Jmpacts 1. Is any discharge observed from any part of the operation? Discharge originated at: 0 Lagoon 0 Spray Field D Other a. If discharge is observed, 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 gal/min? d. Does discharge bypass a lagoon system ? (If yes, notify DWQ) 2. Is there evidence of past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Waste CoUection & Treatment 4 . Is storage capacity (freeboard plus storm storage) less than adequate? D Spillway Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Iden tificr : -·-····-·-1 ..... -.......... . Freeboard (inches): 3S'' 12n2m3 ---------- DYes liJ No DYes DNo DYes DNo N/A DYes DNo DYes fi]No DYes (ENo DYes ()lNo Structure 6 Continued .. ·- I Facili~· Number: Cjs .l -(. 1lf I Date of Inspection 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, seepage, etc.) 6. Aie there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? (H any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) i. Do any of the structures need maintenance/improvement? 8. Does any pan of the waste management system other than waste structures require maintenance/improvement? 9. Do any stuctures lack adequate, gauged markers with required maximwn and minimum liquid level elevation markings? Waste Application 10 . Aie there any buffers that need maintenance/improvement? 11. Is there evidence of over application? 0 Excessive Ponding 0 PAN 0 Hydraulic O verload 12. Crop type · Conv / W/,'f. .. ~ I SovluoN~ 13. Do the receiving crops differ with thos e designated in the Cenified Animal Waste Management Plan (CA WMP)? 14 . a) Does the facility Jack 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? I 6. Is there a lack of adequate waste application equipment? Required Records & Documents 17. Fail to have Cenificate of Coverage & General Permit or other Permit readily available? I 8. Does the facility fail to have all components of the Cenified Animal Waste Management Plan readil y available? (ie/ WUP, ch ecklists, design, maps, etc.) I 9 . Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 21. Did the facility fail to have a actively certified operator in charge? 22. Fail to notify regional DWQ of emergency s ituations as require d by General Permit? (ie/ discharge, freeboard problems, over application) 23. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? 24. Does facility require a follow-up visit by same agency? 25. Were any additional problems noted which cause noncompliance of the Certified AWMP? DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes DYes IC No violations or deficiencies were noted during this visit. You will receive no further correspondence about this "isit. ~No 00No rj]No I!! No ~No IJINo IDNo ~No ~No ~No [II No [JI No Ill No ~No ~No lXI No ~No ~No ~No II] No (g No [»No ··~;~!~~!~~~~y~;~H~~fi!!~~~~~~~t:~~~:D~~~;~~~~~;;:~Ji~!·!:: Re,·ie~·er/Inspector Name Reviewerllnspector Signature: 05103101 --· ·-~ -· _ .. ,.~~-~ .... >:-~ ... -..::.·· .. ~~~-·..:..~~f:: .. _ - './ ~ Continued