820678_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quality
Date ofVisit:ll.-;lr-1 g>f Arrival Time: I .r/ou
Farm Name: L-d-W Ear nt..>
Departure Time: I :z:. /op I County: $~ 1P'-= Region: ;:::~:o
Owner Email:
Owner Name : Phone:
Mailing Address:
Physical Address:
Facility Contact: -D~~...~..I"'-1 Jf-____;J>~~~~~< ___ Title:
Onsite Representative: 5~
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I . Is any di scharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field 0 Other:
a. Was the conveyance man-made?
b. Did the di scharge reach waters of the State? (If yes , notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: ?r ?5~
Certification Number: /If' J ~
Certification Number:
Longitude:
D Yes ~DNA ONE
0 Yes 0 No DNA ONE
D Yes 0No DNA ONE
d . Does the discharge bypass the wa ste management s ystem? (lfyes, notify DWR) DYes 0No DNA ONE
2. Is there ev id ence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a di scharge?
Pag e 1 of3
DYes
0 Yes
~ DNA ONE
~ DNA ONE
11412015 Continued
I
'
I Facility Number: 2'2-= -lo 7 i/ lnate oflnspection: G-.2~-2-otY
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: CJLJ l--.h-w
Spillway?:
Designed Freeboard (in): l'==t tCJ
Observed Freeboard (in): 12 :5:?-
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~
DYes []No
DNA ONE
DNA ONE
Structure 5 Structure 6
DYes ~ DNA ONE
DYes ~ DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~o DNA ONE
DYes ~o DNA ONE
0 Yes @No D NA D NE
DYes [31fo 0 NA D NE
II . Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes [2f"No 0 NA D NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Type(s): D..-e/YtuJt!A.. / rS).v~rf, ..,...-,.-/
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
23 . If sel ected, did the fac ility fa il to install and maintain rainbreakers on irrigation equipment?
Page 1 of3
DYes No DNA ONE
DYes [2T'No DNA ONE
DYes ITNo DNA ONE
0 Yes [3"No DNA ONE
0 Yes 0-No DNA ONE
DYes BNo DNA ONE
DYes CJNo DNA ONE
00ther:
0 Yes [31'Jo
0 Yes [3'f'fo DNA D NE
214/2015 Continued
~
1 ·•
IFacili~ Number: %:J--&z4ff !Date of Ins(!ection: (g-~_j y
~ 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 0'No DNA ONE
the appropriate box(es) below.
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? DYes ~ DNA ONE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes [2J'No DNA ONE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes ~0 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 [3"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 Q-'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. 0 Yes ~0 DNA ONE
0 Application Field D Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes [31'fo DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~ DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes ~ DNA ONE
CommentS (r,~fer to question #):''.l}}xp,~in\any· YES;'~nswers and/or any additio~~l ,recc)oiJDendations or any other coJD.m~~~-·:::"''~f!~·
Use draWings~of facility to bette!-ei]ita m sirilationst(lise additional pages as n~~s~acy)f.f' <· , · "{i~)~;r :· ~j:~~~~y:
Reviewer/Inspector Name:
Reviewer/Inspector Si gnature :
Page3of3
Phone :
Date:
?-tP-.303-'D IS I
6 -Zr:..?O~
214/2015
Date of Visit: I tp ;2-J 7l Arrival Time :I 8': o 0 l Departure Timed Cf 1
, D 0 I County: , i'7> r---Region:
Farm Name: t-,. rl: uJ -f=5;t.l' ~5 ,.::r-/1 e.-L Owner Email:
Owner Name: Phone:
Mailing Address:
I
Physical Address:
Facility Contact: ':?; ; II Y 7J ttfz .$ Title: --~~W-7+---~~~~--------
Onsite Representative: 5-----r:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure D Application Fie ld D Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters ofthe State? (If yes, notify DWR)
c. What is th e estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: ,Pr r4¥
Certification Number: I 'S'Yitrf"
Certification Number:
Longitude:
DYes (Q...No DNA
DYes 0No DNA
0 Yes 0No DNA
d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes DNo DNA
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a dis charge?
DYes
DYes
~No DNA
~No DNA
ONE
ONE
ONE
ONE
ONE
ONE
Page I of3 114/2015 Continued
7l Facility Number: !Date oflnspedion: Jii'2Z?-1 -11?
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: nL.J.. y..J ....... r-V
Spillway?:
Designed Freeboard (in): L9-/9-
Observed Freeboard (in): I-J2:: f1
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
D Yes 0 No D NA D NE
Structure 5 Structure 6
D Yes JZl No D NA D NE
DYes [&No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do anyofthe structures need maintenance or improvement? 3-Yes ~ 0 NA 0 NE
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes 0No DNA ONE
DYes [2?:1 No DNA D NE
DYes [3.No DNA D NE
11. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. 0 Yes ~No DNA D NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc .)
D PAN D PAN> 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Type(s): ~/ mu£ I p v ~"'1~..,./
i
13 . Soil Type(s):
14 . Do the receiving crops differ from those designated in the CA WMP?
15 . Does the receiving crop and/or land application site need imp ro vement?
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination'!
17. Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
Required Records & Documents
DYes ~No 0NA
DYes [2g...No DNA
DYes ~0 DNA
DYes b{lNo DNA
DYes ~0 DNA
ONE
ONE
ONE
ONE
ONE
19. Did the facility fail to have the Certificate ofCoverage & Permit readily available? DYes ~No DNA D NE
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check D Yes C3-No D NA D NE
the appropriate box.
DwuP Ochecklists D Design D Maps D Lease Agreements 00ther: _________ _
21. Does reco rd keeping need improvement? lfyes, check the appropriate box below. DYes ~No DNA 0 NE
D Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers D Weather Code
D Rainfall D Stocking D Crop Yield D 120 Minute Inspection s 0 Monthly and 1" Rainfall Inspec tions D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~No 0 NA D NE
23 . If se lected, did the faci lity fa il to install and maintain rainbreakers on irrigation equipment? D Yes !KLNo D NA D NE
Page 2 of3 2/4/1015 Continued
I
; !Facili!l: Number: .r.r t:, zr-1 I Date of Insl!ection: ~-2::-1 71
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes IEJ...No DNA ONE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes
the appropriate box(es) below.
(g. No DNA ONE
D Failure to complete annual sludge survey DFailure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of frrst 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 Joss 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)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Application Field 0 Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit 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 S,No DNA ONE
DYes (gNo DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
0 Yes j)Z] No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes f:J-No DNA ONE
Phone: 9/p---3'D3--t?/S7
Date: t _. ?-.?0 I 2
11412015
Date of Visit: I 7-.:J?.-.14 Arrival Time: I ft: o 0
Farm Name:
Departure Time:l L'.;.' vV I County: ~,...._, Region : FlO
Owner Email:
Owner Name:
I
Mailing Address:
Physical Address:
Facility Contact: __.:}2 ........ ._) """} 1:...,.,.__-'-:5:=:;· -'..a~~-<.__ ____ Title:
Onsite R epresentative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
l. Is any discharge observed from any part of the operation?
Discharge origi nated at: 0 Structure 0 Application Field
a . Was the conveyance man-made?
Phone:
0 Other:
b . Did the di scharge reach waters of the State? (l fyes, noti fy DWR)
c . What is the estimated vo lume that rea ched waters of the State (gallons)?
Phone:
Integrator:
Certificatio n Number: /r f L/C
Certification Number:
Longitude:
DYes ~No DNA ONE
0 Yes 0 No D NA O N E
0 Yes 0 No D NA O NE
d .. Does the discharge bypass the waste management system? (If yes , noti fY DWR ) D Yes 0No D NA O N E
2. Is there evidence of a past discharge from any part of the operation?
3 . Were there any observable adverse impacts o r potential adverse impacts to the waters
of the State other than fro m a disc harge?
Page I of3
O Yes
D Yes
[8 No DNA ONE
~N o DNA ONE
114120 15 Continued
fFacility Number: #;L-(t? 7$"'
Waste CoUection & Treatment
I Date of Inspection: <f1e= 2-5-)'lp I 6
\ 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) Structure 4
Identifier: etc.R 7-lz:--c..O
Spillway?:
Designed Freeboard (in): L'r ,,P..9
Observed Freeboard (in): t{o l£_(p
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
DYes ~No DNA ONE
DYes ~No 0NA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental tbreat, notify DWR
7. Do any of the structures need maintenance or improvement?
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 tha n 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 ~ No D NA D NE
0 Yes f8l_No 0 NA 0 NE
0 Yes [8-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 ~No 0 NA D NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu , Zn , etc.)
0 PAN D PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12 . Crop Type(s): Prrl??utla: /.at./!"*~..f-rr/
13. Soil Type(s): --~.~v'-'"'-""~-------------------------------
14 . Do the receiving crops differ from those designated in theCA WMP?
I 5. 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. Doe s 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. Do es the facility fail to have all components of theCA WMP readil y available? If yes, check
the appropriate box.
OwuP Ochecklists D Design 0 Maps 0 Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
0 Yes ~3~-J'~o DNA ONE
DYes !»-No DNA ONE
DYes [2f--No DNA ONE
DYes BNo DNA ONE
D Yes 0-No DNA O NE
D Yes I8J-No DNA ONE
D Yes ~0 DNA ONE
Oother:
0 Yes DNA ONE ~N o
0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste T ransfers D Weather Code
0 Rainfall 0 Stocking 0 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? 0 Yes I3J. No D NA D NE
23. If selected , did the facility fail 1!J install and maintain rainbreakers on irrigation equipment? 0 Yes ~No D NA 0 NE
\ Page2of3 11412015 Continued
I
t
·· .. '
JFacility Number: [Date of Inspection: · 7--y ,fbi kJ
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box( es) below.
DYes (gNo
DYes 6?J-No
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the 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/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewe r/I nspector Name:
Reviewer/Inspector Signature:
Page 3of3
D Yes gNo 0 NA 0 NE
DYes ~No DNA ONE
DYes ~No
DYes (i3-No
0 Yes [lf.No
0 Yes ~No
0 Yes !29-No
0 Yes !29-No
DYes ~o
Phone:
Date:
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21412015
-.
··~!!!!~~~~~~~~~~
ompliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ~tine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: l.,r/9-'/Jr Arrival Time: I 8:. '/)0 Departure Time: I '1 ! D D I County:.,Srs~ Region: El! 0
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: -----------------------------------------
Facility Contact:
Onsite Representative:
Certified Operator: 5
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? (Ifyes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: .?~;;r--=
Certification Number: /8"'3/f'V
Certification Number:
Longitude:
DYes ~No DNA ONE
DYes DNo DNA ONE
DYes DNo DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes DNo DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes
DYes
12(1 No DNA ONE
~No DNA ONE
214/1014 Continued
• (Facility Number: I nate of Inspection: s=-;y..-/H
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 Structure3 Structure4
Identifier: O!J. N-z=fJ.I..
Spillway?:
Designed Freeboard (in): t_cr /'l_
Observed Freeboard (in): _3~ 4'1
5. Are there any immediate threats to the integrity of any of the structures observed?
(i .e., large trees, severe erosion, seepage, etc.)
6 . Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes !29-No 0 NA 0 NE
DYes 0No DNA QNE
Structure 5 Structure 6
DYes ~No DNA ONE
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
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes li9-No 0 NA 0 NE
0 Yes ~No DNA 0 NE
0 Yes fiZl.No 0 NA 0 NE
0 Yes ~ No 0 NA D NE
11 . Js there evidence of incorrect land application ? If yes, check the appropri ate box below. 0 Yes [g). No 0 NA 0 NE
0 Excessive Ponding D Hydraulic O verload D Frozen Ground D Heavy Metals (Cu, Zn, etc .)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to lncof1X>rate 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): '&cM,.t/ o.. /ouT"C.$CeL
13 . Soil Type(s):
14 . Do the receiving crops differ from those designated in theCA WMP?
15 . Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
1 7. Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment?
Required Records & Documents
19 . Did the facility fail to have the Certificate of Coverage & Permit readily a vailable?
20. Does the facility fail to have all components of the CA WMP readily available? If yes , check
the appropriate box.
0WUP 0checklists D Design 0 Maps 0 Lease Agreements
21 . Does record keeping need improvement? If yes, check the appropriate box below.
DYes ~No DNA ONE ·
DYes ~No DNA ONE
DYes K1No DNA ONE
DYes g}No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
00ther:
DYes g] No DNA ONE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soi l Anal ysis 0 Waste Transfers 0 Weather Code
D Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? D Yes ~ No D NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes RNo 0 NA 0 NE
Page 2 of3 11412011 Continued
jFacility Number: !Date of Inspection: FIJf-,Po/jj
24. Did the facility fail to calibrate waste application equipment as required by the pennit?
' 25 . Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes jgl No 0 NA 0 NE
0 Yes ®.No 0 NA 0 NE
0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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 in spection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to noti fy the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ll9-No DNA ONE
DYes IE. No DNA ONE 31. Do subsurface tile drains exist at the facility ? Ifyes, 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 penn it orCA WMP? DYes @No DNA ONE
33 . Did the Reviewer/Inspector fail to discuss review/ins pection with an on-site representative? DYes ~0 DNA ONE
34. Does the facility require a follow-up visit by the same agency? DYes [3-No DNA ONE
Comments ,(r~~~r: ~oq~~~on #):Explain any YES answers and/or any additional recommendatioris,:or.any:~~~r.·_commen~~~f£~~~¥~fi~
Use drawings of facilitY· to better explain situations (use additional pages as necessary). _ <. :-· <!,~:!': ~: < · .•
Reviewer/Inspector Name :
Re vi ewer/Inspector Signature :
Page3 of3
Phone: 'T?o~.yp-33 oO
Date : £-I~-pl.Q/5
21412011
ompliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ~utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: JJ{t, In( I Arrival Time: I 1/ D'O
Fa.-mName: L d-W Farm-5 7.::/r~.
Departure Time :I I D ~ D 0 I County:, ~ Region: no
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: -------------------------------------------
Facility Contact: __;:Z::;._I_l _, 11-Y___;J5=-.:66::.;,£.~~-----Title: ~
Onsite Representative:
Cernfied Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and St.-earn Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field
a. Was the conveyance man-made?
0 Other:
b. Did the discharge reach waters of the State? (If yes, notifY DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: -~¥·
Certification Number: I ~3 J( g-'
Certification Number:
Longitude:
DYes ~o DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes
DYes
~No DNA ONE
~No DNA ONE
21412011 Continued
[Facility Number: loate oflospection: eL-L-I tf
Waste Collection & Treatment
'l 4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure4
Identifier: ()Lo( N~c..J
Spillway?:
Designed Freeboard (in): l 7 c:CCf
Observed Freeboard (in): :Jt( ~7
5. Are there any inunediate 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 [g.No DNA ONE
0 Yes 0 No 0 NA 0 NE
Structure 5 Structure 6
DYes fglNo DNA ONE
DYes ~No DNA ONE
If any of questions 4~ 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 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 181 No
0 Yes ~No
0 Yes r8J. No
DNA ONE
DNA ONE
DNA ONE
0 Yes e9 No 0 NA 0 NE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes jgi.No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): ~;ma)a._ J f)t./.,-r-5;:.,...)
13 . Soil Type(s): -...:\).)~~a.:E::s·~--------------------------------
14 . Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the faci lity fail to secure and/or operate per the irrigation design or wettable
acres determination?
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
Page 2 of3
DYes QlNo
0 Yes ugNo
DYes ~No
DYes ~No
0 Yes ~No
D Yes (3.No
D Yes ~No
0 0ther:
0 Yes ~No
D NA ONE
D NA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
D Yes ~No 0NA ONE
214/2011 Continued
• !Facility Number: ~ -~zy-1 !Date oflns2ection: ~~-(.Q-14
;: !
\ ,
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes a No DNA ONE
25 . Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes t2}No D NA ONE
the appropriate box( es) below.
D Failure to complete annual sludge swvey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date offrrst swvey indicating non -compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? DYes ~No DNA ONE
27 . Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes ~No DNA ONE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 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
If yes, contact a regional Air Quality representative immediately.
~No DNA ONE
30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes (gNo 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 I8J. No D NA ONE
0 Application Field 0 Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 0 Yes Qg_No DNA ONE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? D Yes [8No D NA ONE
34. Does the facility require a follow-up visit by the same agency? DYes ~No DNA ONE
Gommeots(.r:-~f~r :to ,questio~.#):-,Explain any YES answers and/or any additional recommendations or any,()tbercoi;o_IJlell "
(Jse;drawi.llgs;or facility:to'iieiter explain situations (use additional pages as necessary). · (; /} ~ · · ·
Reviewer/Inspector Name: ~ &~~
~~_7?J . Reviewer/In spector Signature: ~ ~
Page 3 o/3
Phone: ?to-q:TI-TI(JC
Date: S-L-rZ01¥
21412011
,,
0 Denied Access
Date of Visit: I 71-Z-13 I Arrival Time:l Fr'!vD
Farm Name: f-rl: W F~hnj kit c..
Departure Time: If: OV I County: ¥~ Region: F/t... J)
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: -------------------------------------------
Facility Contact: _...:~f2 ......... i .... l.o..:l f'~--'J3~4f!::-.;;'$~._..,;l...-----Title: I?,~ hl~.,r Phone:
Onsite Representative: Integrator: ,&'.?"'-:!~
Certified Operator: Certification Number: /~"3~
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 ~o DNA ONE
Discharge originated at: 0 Structure D Application Field D Other:
a. Was the conveyance man-made? DYes 0No DNA ONE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No DNA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes
DYes
fiJ No DNA ONE
!3-No DNA ONE
11412011 Continued
!Facility Number: loate of Inspection: 16-2-:13
Waste Collection & Treatment
:X 4 . Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard ?
Structure I Structure 2 Structure3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ,£2.
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees , severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes {g.No
0 Yes 0 No
DNA ONE
DNA ONE
Structure 5 Structure 6
DYes SNo DNA ONE
0 Yes 12JNo 0 NA 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 ofthe structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the w as te 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 !3-No 0 NA 0 NE
DYes ~No DNA ONE
DYes [3.No 0 NA 0 NE
0 Yes IR_No 0 NA 0 NE
II. Is th ere evidence of incorrect land application? If yes, check the appropriate box below. DYes ~N o 0 NA 0 NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc .)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Appli cation Outside of Approved Area
12. Crop Type(s): 1r~Lc /aYJ;rr~c-J.
13 . Soil Type(s): ---.~W~_.@:k:.ll~-------------------------------
14. Do th e receiving c rops differ from those designated in theCA WMP ?
I 5 . Does the receiving crop and/or land application site ne ed imp rovement?
16. Did the facility fail to secure and/or operate per the irri gatio n desi gn or wettable
acres determination?
Pagel of3
_.
0 Yes
DYes
DYes
DYes
DYes
~N o DNA ONE
~N o DNA ONE
~N o DNA ONE
~No DNA ONE
IZl_ No DNA O NE
DNA ONE
DNA ONE
214/2 011 Continued
·r
I
I Facility Number: I Date of Inspection: k _.. 7-I 3
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box.(es) below.
DYes ~No
DYes ~No
DNA ONE
DNA ONE
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structurc(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) certifi cation?
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 p ose 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.
DYes ~No DNA ONE
DYes U4No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes r:aNo DNA ONE
0 Application Field 0 Lagoon/Storage Pond D Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes [;3No DNA ONE
33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes 0,No DNA O NE
34. Does the facility require a follow-up visit by the same agency? DYes jg!No DNA ONE
Co~~~n~s (reftf ~o.~u~~:tion #): Expla~n a~y ~S answers ~~dlor any additional recommendations or any otbe .. ~commel1~ .. ~~::~·~'o._:;,1~;~~
Use draWI.Dgs offacility to better explam satuabons (use addttional pages as necessary). -.,;~,:;;•,;,:•,_!'1:§1:!'! :·
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
Phone: ?to '"!113-33co
Date : ?;--
11411011
ompliance Inspection Operation Review 0 Structure Evaluation
Reason for Visit: ~tine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Denied Access
Date of Visit: I~~~ -OJ Arrival Time:lg,.: co Departure Time: I ~: 0 () I County: .5"/rio.....__ Region: flo
Farm Name: Lcr-vJ P:.a/l'ns ..-:---~Ill.' Owner Email:
Owner Name: La l.C.'f. .~ /t l!:l 1:2:1. 1'.) 1'1,.. s:: Phone:
Mailing Address:
Physical Address: -------------------------------------------
Facility Contact: _....,..,7)L..-4d.J../y....;c.....__,;,B~a~::~o:1a...~'-----Title: ~nn !11_o/, Phone:
Onsite Representative: Integrator: flr;~
Certified Operator: Certification Number: / YJ'(fiV
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 0 Application Field D Other:
a. Was the conveyance man-made? DYes 0No
b. Did the discharge reach waters of the State? (If yes, notifY DWQ) DYes 0No
c. What is the estimated 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
11412011 Continued
I Facility Number: IDate oflnspection: 2:-" Iff'-lA
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 l Structure 2 Structure3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in): 19'
Observed Freeboard (in): 37
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes l29No DNA ONE
DYes 0No DNA ONE
StructureS Structure 6
DYes ~No DNA ONE
DYes ~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the pennit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
0 Yes (g No 0 NA 0 NE
DYes (8_No DNA ONE
0 Yes ~No 0 NA ONE
DYes ~No DNA ONE
ll.Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes [g_ No 0 NA 0 NE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN> 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. CropType(s): ]5>'~ / l)vc-;--s..-,....L
13. Soil Type(s): _ _,UJ~..::;a:::...::.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 detennination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
OwUP Ocbecklists 0 Design 0 Maps 0 Lease Agreements
DYes ~No DNA ONE
DYes J29 No DNA ONE
DYes [27g No DNA ONE
DYes ~No DNA ONE
DYes {53 No DNA ONE
DYes ~No DNA ONE
DYes [gNo DNA ONE
Oother:
21. Does record keeping need improvement? If yes, check the appropriate box below. DNA D 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 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? O Yes Q(J No D NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Page2of3
DYes ~No DNA ONE
21412011 Continued
!Facility Number: rr;L -" 2 r:l I nate of Inspection: £-t ¥:-et?JJ--
1 24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
DYes IE, No
DYes ~No
DNA ONE
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 offJISt survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Otber Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? ffyes, check the appropriate box below.
0 Application Field D Lagoon/Storage Pond D Other:
0 Yes (2!No
DYes ~No
DNA ONE
DNA ONE
0 Yes lX_No 0 NA 0 NE
DYes ~No DNA ONE
0 Yes ~No D NA 0 NE
0Yes ~No DNA ONE
------------------------
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:
Page1of3
DYes IX!No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
Phone: 9/P-~3-::?.>oo
Date: _s-:=-;tr-~
214/ZOI I
Operation Review
Reason for Visit: 0 Referral 0 OOther
Date of Visit: I(,~ I Arrival Time:l/b:oo
Farm Name: 1-t: 11J Fa1m ~ :z;;., ?,
DepartureTime:ljl/pO I County:~ Region:,~?)
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: -------------------------------------------------------------------------
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure D Application Field D Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Phone:
Integrator: Pcr;,1 ~
Certification Number: /tr:3 ~
Certification Number:
Longitude:
DYes ~No DNA ONE
DYes 0No DNA ONE
DYes 0No D NA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) D Yes 0No D N A ONE
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes
0 Yes
~No D N A ONE
~No DNA ONE
214/2011 Continued
-I Facility Number: loate of Inspection: b-,il.,;).-1 (
Waste Collection & Treatment
~. 4. Is storage capacity (structural plus storm storage plus heavy rainfall) le ss than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): I Cf ~
Observed Freeboard (in): v17 vG:.
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., larg e trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes 181 No 0 NA 0 NE
DYes 0No DNA ONE
StructureS Structure6
0 Yes (gl No 0 NA 0 NE
0 Yes J8 No 0 NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses au 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 mana gement 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 improvem ent?
DYes ~No
0 Yes 00 No
0 Yes lXI No
DNA ONE
DNA ONE
DNA ONE
D Yes ~No D NA 0 NE
II . Is there evidence of incorrect land application ? If yes, check the appropriate box below. 0 Yes IE No 0 NA D NE
0 Excessive Ponding 0 Hydraulic Overload 0 F rozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN 0 PAN > 10% or 10 Jbs . 0 Total Phosphorus D Failure to In corporate Manure/S ludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12 . Crop Type(s): 'BermJ~« lou,-;~
l3. Soil Type(s):
14. Do the receiving crops differ from tho se de signated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16 . Did th e facility fail to secure and/or operate per the irrigation design or wettable
acres d etermination?
17. Does the facility lack adequate acreage for land appli cation ?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19 . Did the facility fail to hav e the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all co mpon en ts of the CAWMP readily available? Ifyes, check
the appropriate box.
DYes ~No DNA
DYes [gl No DNA
DYes ~No DNA
DYes GZI No DNA
DYes ~No DNA
DYes ~No DNA
DYes ~0 DNA
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Owu p 0Checklists 0 Design 0 Maps D Lease Agreements Oother: _________ _
2 1. Does record keeping need improve ment? If yes, check the appropriate box below. 0 Yes gNo 0 NA 0 NE
0 Waste Application 0 We ekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Weather Code
0 Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and I" Rainfall Ins pections 0 Sludge Survey
22 . Did the facility fail to install and maintain a rain gauge? 0 Yes ~No 0 NA 0 NE
23. If selected, did the facility fail to install and ma intain rainbreakers on irrigation equipment?
Page 2 of3
0 Yes 129 No 0 NA D NE
21412011 Continued
• [Facility Number: g:;L -G ?91 I nate of Inspection: ' -;ppz -J I
24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes ~ No 0 NA 0 NE
25. Is the facility out of compliance with permii conditions related to sludge? If yes, check 0 Yes 5?J No 0 NA 0 NE
the appropriate box(es) below.
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
DYes fgJ No
DYes (2a No
DNA ONE
DNA ONE
0 Yes j&No DNA D NE
D Yes j:3 No D NA D NE
0 Yes ~ No D NA D NE
DYes ~No DNA ONE
0 Application Field 0 Lagoon/Storage Po~d 0 Other: ___________ _
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3of3
DYes ~No
DYes fs:a No
DYes ~No
DNA ONE
DNA ONE
DNA ONE
Phone: 9( t:J-¥.33-.3.3DD
Date: (::, -e?-,;;z --;:;?lo I I
114/1011
,,
Type of Visit e-compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: le:---//-/0 I Afdval Time: I/ D ~ '6 D I Departure Time: I J I ;3 0 I Cou.nty: 5-~z:r-..-. Region: F""Ji!: 0
Farm Name: L, r/= HI · Fi:unts T:.Ac.a Owner Email: -------------
Owner Name: __ ... L...,.-'-L-/.Lf-Tv ___ s....._ __ 4,t9,;,..,L..,~.m~"'m~(l?f"-=:;..a;,o$~----Phone:
Mailing Address: -----------------------------------------
Physical Address:--------------------------------------------
Facility Contact: Zi/Jy 1?1 ~ S I Title: ------------
PhoneNo: _________ _
Onsite Representative: __ ./o;....~-====--------------
Certified Operator: ____ _.,...,2~a.....,;;;.;;....::'--....._ -----------
Integrator: ~
Operator Certification Number: ..;./'-""fl'-'-""-'~"+-"~o::.---
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
1. Is any discharge observed from any part ofthe operation? DYes ~o DNA ONE
Discharge originated at: D Structure D Application Field D Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Docs discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters ofthe State
other than from a discharge?
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes ~No DNA ONE
DYes ()a No DNA ONE
Page 1 of3 11128104 Continued
I Facility Number: lJ2=-(,zit Date of Inspection I Y, · 11-1 (}
Waste Collection & Treatment
4. Is storage capaci ty (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: t' "'C"cri b t.,.J.
Spillway?:
()
DYes li!No DNA ONE
DYes 0 No DNA ONE
Structure 5 Structure 6
Designed Freeboard (in): ---ln»~....:&fl.::.._,z_ ---+/___.9 __ ------------------------
Observed Freeboard (in): _ ___.t ... :"'"'2--______ Lj........_.z<e;...._. _____________ ------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/large trees, severe erosion, seepage, etc.)
DYes (3 No DNA O NE
6. Are there structures on-site which are not properly addressed and/or managed DYes
through a waste management or closure plan?
~No D NA O 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 structure s need maintenance or impro vement?
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 wast e structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
0 Yes jg!No DNA D NE
DYes 13-No DNA O NE
DYes ~No DNA O NE
D Yes ~No DNA ONE
II. Is there evidence of incorrect application? If y es, check the appropriate box below. DYes ~No DNA 0 NE
0 Excessive Ponding D Hydraulic Overload D Fro zen 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 Acc eptable Crop Window 0 Evidence of Wind Drift 0 Appli cation Outside of Area
12. Crop type(s) ..,+_,.a:::::lUJ:.~IZla....L.'-L!.Lz::l~IQc1JI.-A--------------------------
13. Soil type(s)
14 . Do the re ceiving crops differ from those designated in theCA WMP?
15. Docs th e rece iving crop and/or land application site need improvem ent?
16. Did the facility fail to secure and/or operate per the irri ga tion design or wettable acre determination ?
17 . Does the facility Jack adequate acreage fo r land app li cation?
18 . Is there a lack of properl y operating waste a pplication equipment?
R e\'iewe r!Jnspector Name
Reviewer/In spector Signature:
Page 2of3
DYes jgNo DNA ONE
DYes ~No DNA O NE
DYes ~NoD NA D NE
DYes ~No DNA O N E
DYes !Sa No DNA ONE
I Facility Number: 3Jo-~ M
Required Records & Documents
Date of Inspection I Q/4101
~ 19 . Did the facility fail to have Certificate of Coverage & Pennit readily available?
20. Docs the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps D Other
DYes ~No DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? lfyes, check the appropriate box below. D Yes ~No DNA 0 NE
Q Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections D Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the fa c ility 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 Joss assessment (PLAT) certification?
Otber 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 situation s as required by
General Permit ? (ie/ discharge, freeboard problems, over applic ation)
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 2!No D NA ONE
DYes ~No DNA ONE
DYes til No DNA O NE
DYes LSl.No DNA ONE
DYes rgNo DNA ONE
DYes ~N o DNA ONE
D Yes ~No DNA ONE
D Yes ~No DNA ONE
DYes ~No DNA ONE
D Yes ~N o DNA ONE
D Yes !liNo DNA ONE
D Ye s ~No DNA ONE
12/28104
,
ompliance Inspection 0 Operation Review
Reason for Visit ~ine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: 12-z?J-/) if Arrival Time: I ,I I : 0 01 Departure Time: I /i? ~ od County: ~7 ,.r:-: Region: EJ? ()
Farm Name: L d= kU Farm 5' Jn t!. • Owner Email: -------------
Owne.Nam" &z.c7rf=llkfl/z.c / /1-mmtJn. irk;:,.§<>~ •• .,
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: _,p=--',''-'-/~l---¥-//'--___..z,...S"""""a...........:s-~~----Title: -----------Phone No:---------(
Onsite Representative: -----"L.....::;.~,;;,:::;==----------Integrator: ,1/rr:s~
Certified Operator: _______ _,&..::;,;~;...;.._ -----------Operator Certification Number:
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude: D OD'D"
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field 0 Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notifY DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
DYes [ANo DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes 0No DNA ONE
DYes ~0 DNA ONE
DYes til No DNA ONE
11118104 Continued
' I Facility Number: 5J;?-{, zir Dllte of Inspection
Wnste 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 :t Structure 4
DYes ~No DNA ONE
DYes 0No DNA ONE
St ru cture 5 Structure 6 Stn1cturc I StntctuJe
d
:' __ ,.,' ~ L
1 t'ntificr : ---'-~..;;._c..__;;_·'"""-'-=--__ .::..v_..;;...._' _______ -------------------
Spillway?: ------------------------------------
Designed Freeboard (in): __ ;Jii!:-...-4-Z:..__ ____ __._!_....? ______________ ------------
Observed Freeboard (in): _-.-:k~..:./ ___ ----!'t;,.......,?.___. ____________ ------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes ~No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes j)21No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7 . Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
0 Yes j:MNo 0 NA 0 NE
0 Yes l)j.No DNA D NE
DYes ~No DNA ONE
DYes r:.:8:No DNA ONE
II . Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes l)lNo 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 D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outs ide of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12 . Croptype(s) ~mu rieL /I}C/rrs-&-d
13. Soil type(s)
14. Do the receiving crops differ from those designated in theCA WMP? DYes l2Wo DNA
15 . Does the receiving crop and/or land application site need improvement? DYes 18l..No DNA
16._ Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination'i 0 Yes 12f..No D NA
17. Does the facility lack adequate acreage for land application? DYes ~No DNA
18. Is there alack of properly operating waste application equipment? DYes ti?J.No DNA
Comments (refer to question#): Explain any YES answers and/or any recommendations or any other comments.
Use drawings offacility to better explain situatioits. (use additional pages as necessary):
ONE
ONE
ONE
ONE
ONE
• 1--
f-....
Reviewer/Inspector Name <; Tev;O (.;-J,(.f~ Pbone: :)I?'~..J -;pvO
:1& .7-~?~~'7 Reviewer/Inspector Sipature: ---£/ ......;y .Ji 7£. ==-Date: ;v,)
,. , 1211BIIU Continued
' I Facility Number: &2-b?Y Date of Inspection I z-27~4:>/1
Require-d Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other
DYes \8No DNA ONE
DYes (&No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes r&l No 0 NA 0 NE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 12!' Annual Certification
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections D Monthly and l n Rain Inspections D weather Code
22. Did the facility fail to install and maintain a rain gauge? ·DYes [SNo DNA" ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes 18No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~No DNA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes ~No DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes (;gNo DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes [&No DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes 13No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes ~No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes ~0 DNA ONE
Additional Comments and/or Drawings:
.... -
1-•
12128/fU
·llom~ce Inspection 0 Operation Review 0 Structure Evaluation
Reason for Visit <§1foutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I (S)ilj.:t>(l Arrival Timed 1! D 0 I Departure Time:,, 'D; ot>l County: ~ Region:~
Farm Name: l-rf: t.tJ Forms :l;r~c. Owner Email :-------------
Owner Name: f-t:st~I'Y d: U)~f-cr ltmPIP"zctJe;..s/kPphone: I
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: _,/:.o:.L..ij~L.Jj{~'fc......._ _ __..:B~.:t~i.:c..z.( ___ Title: ----------I Phone No: .!J~/, ¥ -k5Jl.S'
Integrator: ,&~-s z:;:= Onsite Representative: ----"'<""'~====::...._ ____________ _
Certified Operator: £.:c...-wc Operator Certification Number: /Yjl{ Y
Back-up Operator: --------------------Back-up Certification Number:
Location ofFarm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? DYes ~No DNA ONE
Discharge originated at: D Structure 0 Application Field D Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the Sta~e (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 S tate
other than from a discharge?
Page I of 3
DYes D No DNA ONE
D Yes DNo DNA ONE
I
D Yes DNo DNA ONE
D Yes ~N o DNA O NE
DYes !&No D NA ONE
12128104 Continued
r·
! IFacilityNumber: g;2-~7.YI Date of Inspection I b "7f'i?ij$"'
Waste CoUection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
DYes ~No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Identifier: _________________________________________ _
Spillway?:
Designed Freeboard (in): ---,/~ .... 9='--------"d'--"'-7--------------------------
Observed Freeboard (in): ___ lf~/c;....... ____ ___._£"'--._) ________________ ------------
5. Are there any immediate threats to the integrity of any ofthe structures observed?
(ie/large trees, severe erosion, seepage, etc.)
DYes ~No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public bealth or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes !ENo DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
11. Is there evidence of incorrect application? lfyes, check the appropriate box below. DYes (g.No DNA D NE
0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN D PAN> 10% or 10 Jbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area
12. Croptype(s) ,JS-=emah /~/;$~~J
13. Soil type(s) _.J..I.J..:l../.L.~::l.~---------------------------
14. Do the receiving crops differ from those designated in the CA WMP? DYes
I 5. Does the receiving crop and/or land application site need improvement? DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?O Yes
17. Does the facility lack adequate ~creage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/( nspector Signature:
Pagel of 3
DYes
DYes
Date:
12118104
~No DNA ONE
~No DNA ONE
~No DNA ONE
E!No DNA ONE
gNo DNA ONE
~ ..
j Facility Number: ~StJ--"74'
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 ofthe CAWMP readily available? Ifyes, check
the appropirate box. 0 WUP 0 Checklists 0 Design D Maps D Other
DYes !XNo DNA ONE
DYes ~o DNA ONE
21. Does record keeping need improvement? Ifyes, check the appropriate box below. DYes ~No 0 NA 0 NE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification
D Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes IXN"o DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes [itNo 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 ~0 DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes D!No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes jgNo DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes t8tNo DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes
lfyes, contact a regional Air Quality representative immediately
Ci.No DNA ONE
31. Did the facility fail to notify the regional office of emergency situations as required by DYes !2lNo DNA ONE
General Permit? (ie/ discharge, freeboard problems, ove r 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 ISl.No DNA ONE
Pag e3 of 3 12128104
I Facility Number I f(d-H .0.?~JI ~vision of Water Quality s.!farV
0 Division of Soil and Water Conservation ?~b -u? 0 Other Agency
Type of Visit 9-t'!Ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~e 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: l~.a¥fi?/l Arrival Timed 9": DO Departure Time: I )/,'ct;;> I County: .... ~i""-Region: ,CR7)
Farm Name: '-rf=t(/ ra/in-1? ~e;,. Owner Email: ------------
Owner Name: Hr~ '1 r)= U/zlf¢rC ~Mt?h/ f'kis 'k-.55 Phone: I q_u..L..
Mailing Address: ----------------------------------------
Physical Address:-------------------------------.,....----------
Facility Contact: $; / f 't &6.$ Title: ---------Phone No:~-b ~PJS"
I ~ 5t;..t( -;:76¥V
Onsite Represe ntative: wdfcr: Amnzf2?1~ Integrator:----------------
Certified Operator: -b.8....L..:.I...J/u/...,7~----_.,..._J? .... a~e.-:S.._S....._ _____ _ Operator Certification Number: -------
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude: D OD'D"
Design Current Design Current Design · ~C'urr:~nt
. ~ . ~ .. . ...
Swine Capacity Population Wet Poultry Capacity Population Cattle Ca-pacity Popu-lation
ID Wean to Finish I I
'·
10 La~er I I I:
ODairy Cow ' i
K ! Wean to Feeder :o Non-Lave1 D Dairy Calf
.feeder to Finish 1 /;;nKD S;:)../1 D Dairy Heife1
Farrow to Wean D Dry Cow I
D Farrow to Feeder
. Dry Poultry 0 Non-Dairy 0 Layers
;
D Farrow to Fi ni s h ! D Beef Stockel 0 Non-Layers i
0 Gi lts D Beef feeder ;
' 0 Pullets D Boars
I
D Beef Brood Cow 0 Turk eys ! -.. ··-~· .. -· •. -·-
Other 0 Turke y Poults '
' [~J ID Other I I J 0 Other Number of Structures:
·-·· ..
DischaTges & Stream Impacts
I . Is any discharge observed from any part of the operation? DYes lf1No DNA O NE
Discharge originated at : 0 Structure 0 Application Field 0 Other
a , Was the conveya nce man-made? DYes 0 No DNA ONE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No DNA ONE
c. What is the estimated vo lume that reached waters of th e State (gallons)?
d. Does di scharge bypass the waste management system? (If y es , notify DWQ)
2 . Is there evidence of a past discharge from any part of the operati on?
3. Were there any adv erse impact s or potential adverse impacts to th e Waters of the State
other than from a discharge?
DYes 0 No
DYes Kl.No
D Ye s ~N o
12/28104
DNA ONE
DNA O NE
DNA ONE
Continued
!Facility Number: {').-~?fJ Da te of Inspection l~-o(7
Waste CoUcction & Treatmen t
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste le ve l into th e structural freeboard?
Structure 1 Structure2 Structure 3 Structure 4
D Yes ~No DNA O NE
DYes 0 No DNA ONE
Structure 5 Structure 6
Identifier:--------------------------------------
Spillway?:
Designed Freeboard (in): __ ..._l_-}-....._ ___ _.d""-1~---------------------------
Observed Freeboard (in): __ _.1~7~--__ ..;:b;;..J~--------------------------
5. Are there any immediate threats to the integrity of any of th e structures observed?
(ie/ large trees, seve re erosion, seepage, etc.)
DYes ~No D NA ONE
6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE
through a waste management or clo sure 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 stucture s lack adequate markers as required by the pem1it ?
(Not applicable to roofed pit s, dry stacks and/or wet stacks)
9. Does any part of the waste management system othe r 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 Kl...No DNA O NE
DYes ua_No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
11 . Is there evidence of incorrect application? I f yes, check th e appropria te box belo w. D Yes (Sa.No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Gro und D Heavy Metals (Cu, Zn , etc.)
0 PAN D PAN> I 0% or 10 lb s 0 Total Phosphorus D Failure to Incorporate Manure/S ludge in to Bare Soi l
0 Outside of Acceptable Crop Window 0 Evi den ce of Wind Drift 0 Application Outside of Area
12. Croptype(s) ,_Mrmak. / /Jv-c"'t"~r:eJ
13 . Soil type(s) _ _../k'.=..=4iJ~c::~------------------------------
14. Do the rec eiving crop s ditfer from those designated in the CA WMP? D Yes f&l.No D NA O NE
15. Does the receivi ng crop and /or land appli cati on site need improvement? D Yes (;B1 No D NA O NE
16. Did the facili ty fail to secure and/or operate per the irrigation des ign or wettabl e acre detennination?D Yes !2iNo DNA ONE
17. Does the faci li ty lack adequate acreage for land applicati on? D Yes Ill No D NA O NE
18 . Is there a Jack of properly operating waste application equipment? D Yes ~No DNA O NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
jJ;fft:. ~ p~htit-.5 h~~,_ ~~~Jri!"J: Cal( v/)(41'1~~ a.vt A~ v-t: t:l tJ ~ w ~brer~ .... -
)~ ,-{--~A:'P:
I-....
Reviewer /Inspector Name )~~ fd.-.~ Phone: qt.D-~33--;-J 3 oo
Reviewer/Inspector Signature: .....,# ~ ...M..// Date: 1-£~ ttoo.z
12128104 Continued
I Facility Number:a= -~7~ Date oflnspection l?#fEOP
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? lfyes, check
the appropirate box. 0 WUP 0 Checklists D Design D Maps D Other
DYes J81No DNA ONE
DYes El.No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes iJ No 0 NA 0 NE
D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification
D Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections D Monthly and 1" 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 00No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes I&'J 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 129-No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes p(~No DNA ONE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by DYes IK)No DNA ONE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE
33. Does facility require a follow-up visit by same agency? DYes ~0 DNA ONE
Additional Comments and/or Dra"ftings: ... -
f--...
12128104
Type of Visit <te'Ompliance Inspection 0 Operation Revi ew 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ~tine 0 Complai nt 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Vis it: I ~(9-0iPI Arrh·al Time: I &':' D t> Departure Time: I?! t:>O I County:. ~1'2!"?"==' Region: F/?p
Farm Name: h d-UJ Grm i . Bt:.. Owne r E ma il : ___ ....;...,. ________ _
I
Owner Name: hAcrt,trWaf.:f?rA-mtnDni rt=Lai.$ 75«i-$ Phone:
Mailing Address: f'7)~ m ,:! O.a.n ; /::' L !< J. J. 'R a $ c b D,. 0 N (..
Phys ical Address:----------------------------------------
Fa cility Contact: -"l?PL-,.j 1'""'4~v--'B=...a........:~...:.$:....,_ ____ Title: ----------Phooe No: ____________ _
Onsite Representative: _.r..S:-=~=..:;,;;,=-------------Integrator: ,P' r.t.z;;,z:::...
Cer tified Operator: ..fpc.~""· Operator Certification Number : -----..---
B ack-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD 'D " Longitude:
Di sc harges & Stream Impac ts
I . Is any discharge observed from any part of the o perati on? D Yes [XNo D NA O NE
Di sch arge originated at: 0 Structure 0 Appli catio n Fie ld 0 Other
a. Was the co nveyance man-m ade?
b. Did th e d isc harge reach wate rs ofthe State? (If yes, notify DWQ)
c. What is the e st imate d volum e that reached wa te rs of the State (gall ons)?
d. Docs d ischarge bypass the waste management system? (If yes, notify DWQ)
2. Is there evid e nce of a past di sc harge from any part of the operatio n?
3. Were there any adve rse impacts or potentia l adverse impacts to th e Waters of the State
othe r than from a discharge?
Page I of3
D Yes [2iNo D NA O NE
D Yes ~No DNA O NE
D Yes ~0 D NA O NE
D Yes ~No D NA O NE
D Yes £)No D NA O NE
12128104 Continue d
·I Facility Number: f?= -b z?l
I
Date oflnspection I/,;.-;:?-0 b
Waste Collection & Treatment
• 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
_Structure 1 Structure 2 ~ Structure 3 Structure 4 ·-----
DYes ~No DNA ONE
DYes lla._No DNA D NE
Structure 5 Structure 6
Identifier: ______ ---------------------------------
Spillway?:
Designed Freeboard (in): --/o''/~-;--1<J:t--. ___ --~rX::..!::....-49~------------------------------
Observed Freeboard (in): ----==..---_~#::.~.--.IF----__ . ..:={e~::.....,;O~---------------------------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes 181No DNA ONE
(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 12Y_No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? 0 Yes ~No 0 NA 0 NE
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~No DNA ONE
0 Yes IRJ.No DNA ONE
DYes IXJNo DNA ONE
11. Is there evidence of in correct application? Ifyes, check the appropriate box below. 0 Yes I8'J No DNA D NE
D 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 D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Ac ceptable Crop Window 0 Evidence of Wind Drifl D Application Outside of Area
12. Crop type(s) Xrrmu)!(_ B-et!' z~ lz~&tai,.,.. c2r4-zr=
13 . Soil type(s) Wa]S
14. Do the receiving crops differ from thos e designated in the CA WMP?
15. Does the receivin g cro p and/or land application site need improvement?
DYes
DYes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination/ D Yes
17. Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste application equipment ?
DYes
DYes
OO'No DNA
~No DNA
~No DNA
~No DNA
~No DNA
ONE
ONE
ONE
ONE
ONE
12128/04 Continued
·I Facility Number: fr,? -t,zit
'
Date of Inspection I fo -i?-q ~
, 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? Ifyes, check
the appropirate box. D WUP 0 Checklists 0 Design 0 Maps 0 Other
DYes ~No DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes I!(J No 0 NA 0 NE
0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification
D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes !X1No DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes ~No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~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 .IgJ No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes [i\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 in specti on did the fac ility pose an odor or air quality conc ern ? DYes ~N o DNA ONE
If y es, co ntac t a regional Air Qua li ty representative immediately
3 1. D id th e facility fail to noti fY the reg ional o ffice of emergency situations as required by DYes
G eneral Permit? (i e/ di scha rg e , rreeboard probl ems, over applic ation)
~N o DNA ONE
32. Did Reviewer/In specto r fai l to discuss re vie w/inspec tion with an on-site repre sentative? D Y es 2}No DNA ONE
33. Does fa cility require a follo w -up vi sit by same agency? DYes DNA ONE
DraWings: ..
12118104
e Division of Water Quality· ,
, 0 Division of Soil and Water.Conservation
0 Other Agency '· · ·
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: !51/s@ Arrival Time: J .?.' ~Jt> I DeparturcTime: ._l ___ ___.l County: Sa.,....f.S42AJ Region: FR.U
Farm Name: .Ivtc.. Owner Email: --------------
Owner Name: Leu• v-'1 ! W • I.e-.~ v-A m -o a Phone: ~ I 0) S~ ~ -
Mailing Address: ~':...:'-:...~~f~'-~___,!m~=-c.---!JQ~CL~..~...,~;J:;c .. .LJil.__-~.R~c/J.~.-------'r.<~I2D.i.S5ic...dl2...,1Z..Lt~o~.-4 --L.N..:L-~c...-. __ _
Physical Address:-----------------------------------------
Facility Contact: ______________ Title:-----------Phone No:---------
Integrator: _ ___.!f.!.....!....,..s;c.o...:.ss..+..!.....!c.~7:..:S....~--------Onsite Representative: _ _IJ(3...._':!.-l•l~f:..:1'--.11.(3..t..~O.o&..:~.S.k.;S~-------
Certified Operator: S ". I 'Y B o..~'------Operator Certification Number: _"*'_:..../!!..f~3o!.-J/!..:K~-
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 Capacity Population Cattle Capacity Population
I ' oao I -, Of/) I F-0=-L_a_ve_r ---+1----+-----11_,·. b Non-Laver . .
lilt! Wean to Finish
0 Wean to Feeder
I
0 Feeder to Finish
0 DairvCow
0 DairvCalf
0 Daif-yHeifeJ I
0 Farrow to Wean
0 Farrow to Feeder
0 Farrow to Finish
0 Gilts
0 Boars -
0 Dry Cow ' I
0Non-Dairv :
0 BeefStockl:r :
0 Beef Feeder I
0 Beef Brood Cow
I
I
------
Dry Poultry
0 Layers
0 Non-Layers
0 Pullets
0 Turkevs
Other 0 Turkey Poults
0 Other i !O Other Number of Structures: ~:
Disrharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes ~No DNA ONE
Discharge originated at: 0 Structure 0 Application Field D Other
a. Was the conveyance man-made? DYes 0No DNA ONE
b. Did the discharge reach waters of the State? (If yes, notif)' 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 from any part ofthe operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'!
DYes 0No
DYes [J]No
DYes !jlNo
11128/04
DNA ONE
DNA ONE
DNA ONE
Continued
L. . ' I Facility Number: 9' .2.-G 71
Waste Collection & Treatment
Date of Inspection I S/lt I 06j
4 .. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard ?
Structure I Structure 2 Structure 3 Structure 4
Identifier: ---r /-· . .a
DYes IX!No DNA ONE
DYes 0No DNA ONE
Structure 5 Structure 6
Spillway?: /.J/ II /9 '(
Designed Freeboard (in): < /"f 11
G /~ /'1....~::7 __________________ _
il (, ,, 1 -------
Observed Freeboard (in):------------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees , severe erosion, seepage, etc.)
DYes ~No DNA ONE
6. Are there structures on-site which are not properly addressed and/or managed DYes [XJNo DNA ONE
through a waste management or closure plan?
If any of questions U were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7 . Do any of the s tructures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the pennit?
(Not applicabl e 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
0 Yes liJ No D NA 0 NE
0 Yes (jJ No D NA 0 NE
DYes [jNo DNA ONE
11. Is there ev idence of incorrect application? lfyes, check the appropriate box below. 0 Yes 00 No DNA 0 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 D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area
12 . Crop type(s) _ _./3~c...!,.:....~f:!'!~J.!I:loe:!II""""--''7!!J-I.r~·..!:&.A'~&~-=.J.-L:.--=.S~G;;~----l::o.::.:::.s:_ ________________ _
13 . Soil type(s) Wo.. .8
14 .
15.
16.
17.
18.
Do the receiving crops differ ti-om those designated in theCA WMP? DYes
Does the receiv ing crop and/or land application site need improvement? ljl Yes
Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination!O Yes
Does the facility lack adequate acreage for land application? DYes
Is there a lack of properly operating waste application equipment'! DYes
"''\c..
p 0 s.s ~ l.lc... + o pa--,vc.~
~<..~ovc..dL c:t.)
o(C.._0-1 c_ ·+o +-~.c. b-e..,.-~~
Reviewer/Inspector Name
Reviewer/Inspector Signature:
00No DNA ONE
0No DNA ONE
~No DNA ONE
ljl No DNA ONE
[XI No DNA ONE
trl hi I ~.r-
12/28104 Continued
),
' l
I Facility Number: s; .1 -(., 791 Date oflnspection 1~/Jij)/~..)-1
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. D WUP 0 Checklists D Design D Maps 0 Other
21. Does record keeping need improvement? Ifyes, check the appropriate box below.
0 Yes 1(1 No 0 NA 0 NE
0 Yes liJ No 0 NA 0 NE
DYes !21No DNA ONE
0 Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification
0 Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes 00No DNA ONE
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes DNo 00NA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes &I No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes 0No DNA [.il NE
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 DNo DNA (JNE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes fi] 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 o f th e in spection did the facility pose an odo r o r air quality concern? DYes [ll No DNA ONE
If yes, contac t a reg io nal Ai r Quality representative imm ediately
31. Did th e facility fai l to no ti fY the regional office of emergency situatio ns a s required b y DYes ~N o DNA ONE
General Permit? (i e/ dis charge , freeboard problems, over appl icati o n)
32. Did Review er/Ins pecto r fa il to di scuss revi ew/in spection with an on-s ite representative? DYes ~No DNA ONE
33. Does facil ity re q uire a foll o w-up vi s it by same agency? DYes l:iiNo DNA ONE
12118104
Type of Visit e Compliance Inspection 0 Operation Review 0 Lagoon E val uation
Reason for Visit e Routine 0 Complaint 0 Follow up 0 Emergency Notificat ion 0 Other 0 De nied Access
II II D"tc of\·,·._,·t·. I ~!.JJ}4uiT•"m c·.l 9 : So facilif)· ~umber 1 9;2 H ~7 i · ' · LC !..:. L --
L _ _:~.:.:.:,.:...:,_:..:..:,~_::::=:::::::::::__:::,:~:::~--_j! !0 ~ot Operatinnal 0 Belnw Thres hold J
IJ Permitted ~ Certified
l ~
[] ConditionaJl:_\· Certified [] Regi~tered Date Last Operated or Abol"e Threshold :
Farm ?\ame: W lac... Count)·: s~""'fH9J'=! FJe.D /. ' .r?~ c,s-.zr ~,.,...
Owner !'\arne: _-o:::L,._c::...,.r'-'r"-"''1f---"-'--..... W=:ot.::..&../..Lf~c..~t~=---'Ar....:.<mr..:....:.mt.:..:..:.o..,w....._s _ Phone No: L'l' I~ .J ~ f-.Y-C ~ ~_s-
Mailing Address: I' 8G m e. .Oot1i c, I Rcl
Facility Contact: Title: -----------Phone !\o: ---------
Onsite Representatil"e: /},'lly /:lasS Integrator : _--Jflt....L..::~~~.sL*.::..::"'~~~c.::...._.;..h_e~=~::..Df.£~~---
Certified Operator: (?,·ILy & S S' Operator Certification Number: ;,/1 /J' 3 ~ 3
Loation of Farm:
[J Swine 0 Poultry 0 Cattle 0 Horse Latitude .._ _ _.1•._1 _ __.I• 1._ __ __.1 " Longitude ~.-___.~1 • L-1 _ ....... 1· L-1 _._.I ..
Design Current Design Current Design Current
Swine Capacin· Population Poultry Cal!acin· POf!UlatiOD Cattle Caf!acin· Pof!ulation
[]I W~an to Feeder &tJro t, i>llo Po ~::aver I I I lo Da!!;y I I I 0 Fe~der to Finish :o Non-Dail"\':
0 Farrow to Wean ID Other I 0 Farrow to Feeder I I
0 Farrow to Finish Total Design Capacity I I 0 Gilts I I 0Boars Total SSLW
Number of Lagoons I r2!. I ID Subsurface Drains Present ·liD Lagoon Area jO S~ra,.-Fi~ld Area I
Holding Ponds I Solid Traps I I ID l'io Liguid Waste Management Svstem
Discba r~es ~ Stream Jmoacts
l. Is any discharge observ ed fro m any part of the operation?
Di scharge originated at : D Lagoon 0 Sorav Field 0 Oth~r
a. }j dis charge is observ ~d, was the conveyance man-made?
b. If di scharge is obs::l"\'ed. did it reach Water of the State? {If y~s. notify DWQ )
c. If discharge is obsel"\·ed . 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 pan of tb~ operation?
I
3 . Were th~re any advers~ impacts or potential adverse impacts to the Waters of the State oth~ than from a discharge?
Waste Collection &: Ireanneot
4. Is storage capacity {freeboard plus storm storage) less than adequate?
Identifier:
Freeboard (inches):
05/03101
Structure l
I
Structure 2 Structure 3
;J
0 Spillway
Structure 4 Structure 5
.• ~ ;: ,I;,\. .. ' -..
0 Yes 111 No
D Yes 0 No
DYes 0 No
#/A
D Yes 0No
D Yes ~No
D Yes [I!No
DYes ~No
Saucture6
Continuu
\.
I Facility Number: 9.! -(. 7¥ 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. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions ~was answered yes, and tbe situation poses an
immediate public health or environmental tbreat, notify DWQ)
7. 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 sructures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? D Excessive Ponding D PA.i'J D Hydraulic Overload
12. Crop type 8~rmuJ... / Stns /J ftcin O.S (l<vc.)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility la ck adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WlJP, checklists, design , maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reportS)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency si tuations as required by General Permit?
(iel discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fai l to discuss review/inspection with on-site representative?
24. Does facility require a fo llow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified A WMP?
DYes ~No
DYes EINo
DYes liJNo
DYes I]INo
DYes [)JNo
DYes [JINo
DYes lXI No
DYes [)]No
DYes [iiNo
DYes III No
DYes fi]No
DYes l(lNo
DYes III No
DYes 0No
DYes ri!No
DYes [I No
DYes (l No
DYes CiiNo
DYes ~No
DYes i:iJ No
DYes it] No
DYes ljJ No
I[] No ~iolations or deficiencies were noted during this visit. You will receive no furtber correspondence about this visit.
So~ i .Sco.""'-t>l' \..,. ~loo..f"-~
Rskc.~ tn~. Be:-»~ t-o
~1.. c:.. Ffto. rnr. 8~~-·~
Re,·iew·er!Inspector Name
Reviewer/Inspector Signature:
05/03101
e~ ~oo3
c.-~ ~ "'k. ().... J..l
,_.._.fc.. 6 .p ., :15:'
rca-fc... i .u CJtfAJ/fll~, L w:/1
ti./A.:. ... c.. i . 0-" C. -r "C<~ +c.>
Date: 4/ ..2 I/ Pt/
Continued
I-•
r I
!
.
.\
il
. ,_
·=,·-~~:et~~-c.:-7 ·"'g~~s.~:,~,w.~~~r~.~¥~~:t~~t~~~~.vr.:::.:u;kt.·~e:-~M!:..:::r~,.~:-:;z;~,--
[] Division of Soil and Water Conservation D Other Agency
ivision of Water Quality
Date oflnsp~tion I /l?-1 tl_,j
Facility Number I 11-H (,7~
Time oflnsp<:ction l/3: 30 124 hr. (hh:mm)
C Registered Certified C Applied for Pe.rmit C Permitted IC Not Operational I Date Last Operated: ........................ ..
Farm Name: ... L ... *-.. 4J. ..... £t?.t..r.::~.5.1 ... ~~.~................................................... County: ... ~~ .............................................. ..
Owner Name: ... k.QI:'.~ ....................... ,4m .. ~.O.~.S:....................................... Phone No: ........... 9...~{::::. ... ~.~.3..~.= ............................. .
Facility Contact: ..... b.g,r.:~ ....... ~~.OM ................... Title: .... 0..~.~.~:r:::................................. Phone No: ....... $.~.~ .................... .
Mailing Address: ....... jf.~S.::: .... M.~ .. D.~a.~.e.\...Lt...................................... . .. ~~.b.o.r.Di{ ... N .. ~ .......... :.................. :?.-.~J..r..~
Onsite Represcntati\·e:.t~ ..... f3.f\.f.e.-fD.o±......................................... lntegrator: ..... [C~.S..f:~.~ .......................................... ..
Certified Operator~ ..... .6 .. a.LT ............................ t>..A.,.,$..5........................................ Operator Certification Number~ .... I.["J.o/:.r.. ........... ..
Location of Farm:
I I ~ID Subsurface Drains Present UD Lagoon Area
,:-~:.s-,;o.;·F:' ~:_._=,):;,".fl;'=':v-·---=--.=:?.·-------- -------------------·. . . . . ........ --· :~S!';;,~;:::.~·:'e£i 1D No Liquid Waste Management System
General
I. Are there any buffers that need maintenance/improvement?
2. Is any discharge obser:ved from any part of the operation?
Dis charge ori_ginated at : D Lagoon D Spray Field D Other
a. If discharge is observed. wa' the conveyance man-mad e?
b. If discharge is observed. did it reach Surfac<?. Water? (If yes. notify DWQ)
c. If di sc harg<! is observed, what is the estimated flow in gal/min?
·d . Does di sc harge bypass a lagoon system? (If yc::., notify DWQ )
3. Is there evidence of past di sc harge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a di scharge ?
5. Does any part of the waste manag em ent system (other than lagoons/holding ponds) require
maintenancc/i mp rovement?
6. Is facility not in compliance with any ap pli cable setback cri teria in effect at the time of desig n?
7. Did the fa cility fail to ha\'e a certified operator in re sponsible charge?
7/25/97
DYes ~~o
DYes 1~o
DYes DNo
DYes DNo
DYes 0No
DYes ~· DYes No
DYes ~0
DYes ~o
DYes ~
Continued ou back
I ~ ......
I
) Facility Number: 87.. -(., 7f J
8. Are there lagoons or storage ponds on site which need to be properly closed?
Stmcturl'S (Lagoons.Holding Pnnds. Flush Pits, etc.}
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
lO. Is seepage observed from any of the structures?
II. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or emironmental threat, notify DWQ)
Structure 5
DYes ~o
Structure 6
DYes Mo
DYes ~No
DYes ~o
13. Do any of the structures lack adequate minimum or maximum liquid level markers? DYes ~0
Waste Application
14. Is there physical evidence of over application? DYes ~o
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
:~: ~o:~:civ=~-~:~if.::;::-::~;~;~~~;::;~:;~~)~~----~~=-~=··-
17. Does the facility have a lack of adequate acreage for land application? DYes ~o
18. Does the receiving crop need improvement? 0 Yes ~No
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
22. Does record keeping need improvement?
For Certified or Pennitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified A WMP?
25. Were any addi.tional problems noted which cause noncompliance of the Permit?
' : ~~: vi~l_ati~ns: or deficiencies were: noted:dur~n~ -~is: ~i~t~ ~ou ~will rece_ive· no : fuJ:t~~r : :
:-:-correspondence about this. visit> : -: . . . -. . . ' -. -.
DYes Jilt No
DYes ~o
DYes J5{No
0 Yes }(J.No
DYes p!lNo
DYes ~No
DYes IZfNo
7/25/97
Reviewer/Inspector Signature: Date: /IJ -)'/-9 7