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Home My WebLink About820691_INSPECTIONS_20171231NORTH CAROLINA Department of Environmental Quality Date of Visit:~~ Arrival Time:!/; 0 0 I Departure Time: I 2: r 0 I County:~ Region: !=)?:; D FarmName: ${?-t.Q/j &z;t;~ /7L47-1 ~;J-Owner Email: Owner Name: J?Y:Jvrd/ &~p-o--Phone: Mailing Address: Physical Address: Facility Contact: ~a# ~-;{;;.-2 c--..-Title: 3hurt"r~r-Phone: Onsite Representative: ?:~ Integrator: ..,.m'-L.&.~-..te..£¥----:.,JC--------- Certified Operator: Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts 1. Is any di scharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Application Field a. Wa s the conveyance man-made? 0 Other: b. Did the discharge reach waters of the State? (If yes, notify DWR) c. What is the estimated volume that reached waters of the State (gallons)? Certification Number: J.~L/ Certification Number: Longitude: DYes ~ DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE 0 Yes 0No DNA ONE 0-' d. Does the discharge bypass the waste management system? (If yes, notify DWR) 2. Is there evi dence of a past discharge from any part of the operation? 3 . Were th ere any observable adverse impacts or p otential adverse impacts to the waters of the State other th an from a di sc harge? Page 1 of3 0 Yes 0 Yes ~0 DNA ONE DNA ONE 214/2015 Continued ~~~~--~~~~ ', I Facility Number: o-;:?--/;Y I I Date oflnspection: lb.?'EJB ~~ Waste CoUection & Treatment ' ' ri 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? f a. If yes, is waste level into the structural freeboard? Structure l Structure2 Structure 3 Structure4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? 0 Yes 0 Yes 0 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 Aoplication I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes DYes DYes DYes [2(No DNA ONE g.No' DNA ONE ~ DNA ONE ~ DNA ONE II . Is there evidence of incorrect land application? Ifyes, check the appropriate box below. 0 Yes EJN'o DNA D NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12 . Crop Type(s): 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reguired Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. Owup Ochecklists 0 Design 0 Map s 0 Lease Agreements DYes DNA DYes DNA 0 Yes DNA 0 Yes @'No DNA DYes (2t'No DNA DYes @'No DNA DYes ~ DNA 00ther: ONE ONE ONE ONE ONE ONE ONE 21. Does record keeping need improvement? Ifyes, check the appropriate box below. DYes ~ 0 NA 0 NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code 0 Rainfall D Stocki ng D Crop Yield 0 120 Minute Inspections D Monthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~o 0 NA D NE 23 . If se lected, did the fac ility fa il to install and maintain rai nb reakers on irriga tion equipment? 0 Yes ~o 0 NA D NE Page2of3 21412015 Continued \ I ... IFacili~ Number: fJ:).. -& <-t-L !Date of Ins~ection: • /J-;;z'F-V &;-" 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes lZPio DNA ONE ~0 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes DNA ONE the appropriate box(es) below. D Failure to complete annual sludge survey 0 Failure to develop a POA for s ludge levels D Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus Joss 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? 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 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 [i?o DNA ONE DYes ~ DNA ONE 0 Yes ~ DNA ONE 0 Yes 0'N'o DNA ONE DYes ~ DNA ONE DYes ~0 DNA ONE DYes ~ DNA ONE DYes 0'N'o DNA ONE DYes ~0 DNA ONE Phone: zy-30 ~-/) /-.:;7 ' Date: //-_;ZJ--~/g-- 21412015 Operation R eview 0 Follow-u Referral 0 Date of Visit: I(-9 /~( Arrival Time: I t(,'h I Departure Time: I J"':•ri:;;; I County:~~ FarmName: 7oa4J J=>~j;:,l'3rT-rt:..5~ ~ OwnerEmail: Owner Name: ~~J), Mailing Address: Physic a l Address: Facility Contact: Title: Onsite Representative: Certified Operator: Back-up Operator: Location of Farm: L a titude: Discharges and Stream Impacts I. Is any discharge observed from any part of the op eration? Di scharge originated at: D Stru ct ure D Application Fiel d a. Wa s the con veyance man-made? Phone: D Other: b. Did th e discharge reach waters of the State? (If yes . notify DWR) c:. What is the estimated vo lume that reached waters of th e State (gallo ns)? Phone: Integrator: J?~ Certification Number: Certification Number: Longitude: D Yes ~o D Yes D No D Yes D No d . Does the discharge bypa ss the waste management system? (If yes, notify DWR ) D Yes D No 2. Is the re e vidence of a pas t discharge from any part of th e operation? 3. Were th ere any observable adverse impacts or potential adverse imp ac ts to the waters of the State other tha n fro m a discharge? DYes .f8l_No DYes ~ Region: ffD D NA ONE DNA ONE DNA O NE D NA ONE D NA O NE D NA O NE Page I of3 21412015 Continued \!Facility Number: l~ate oflnspection: /-~6-l Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): 19: Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? O Yes ~ No 0 NA 0 NE 0 Yes D No D N A D NE Structure 5 Structure 6 0 Yes !2LNo 0 NA 0 NE 0 Yes ~No 0 NA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~No DNA ONE 0 Yes ~ No D NA 0 NE DYes ~No DNA 0 NE DYes ®No 0NA ONE II . Is there evidence of incorrect land application? If yes. check the appropriate box below. 0 Yes (:3 No D NA 0 NE 0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metal s (Cu, Zn, etc.) 0 PAN D PAN> 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/S l udge into Bare Soil D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area 12 . Crop Type(s): .7J.r.("7'11 uJ.t:t. J /lCK~ r'-r/ 13. Soil T ype(s): .-z4.« /1.:, 1/VrJ 14. Do the receiving crops differ rrom'ii::e designated in theCA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 22. Did the fa cility fail to install and maintain a rain gauge? 23. I f selected, did the facility fail to install and maintain rainbreakcrs on irrigation e quipment? Page2of3 DYes ~No DNA ONE f21.._Yes ~ DNA ONE DYes ~0 DNA ONE DYes jgNo DNA ONE DYes j3No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE 00ther: DYes ~N o DYes ~No DNA ONE D Yes ~o D NA 0 N E 214120 15 Continued \!Facility Number: ~-/rCJ-1 !Date of Ins~ection: /-7 :;?h/71 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes JZ}_No DNA ONE • 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes J;3No DNA ONE the appropriate box( es) below. 0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ~pplication 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/Inspecto r Name : Revi ewer/Inspector S ig nature : Page3 of3 DYes 1/K.No DNA ONE DYes 1:8-.No DNA ONE DYes ~0 DNA ONE DYes ~0 DNA ONE DYes ~No DNA ONE ~Yes 0No DNA ONE DYes lB. No DNA ONE DYes ~No DNA ONE 0Yes~o DNA ONE Phone : 9zp-Jo3-tJJ§t Date: /-9'---~/7, 21412015 Date of Visit: I 'F-Lr-t/1 Arrival Timed Jtl/dO I Departure Timed p• 5?) ~· I County:_.~~ . Region: f7< U Farm Name: .lv~J J?~JJ %J;. (S tt--'~ 6-l'/l't ~wner Email: Owner Name: 7? 7z--~_,..-' Phone: Mailing Address: Physical Address: Facility Contact: Onsite Representative: Certified Operator: Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts I . Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Application Field 0 Other: a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWR) c. What is the estimated volume that reached waters o f the State (gallons)? Phone: Integrator: ,!f/rz~ Certification Number: /,'74q Certification Number: Longitude: 0 Yes (X_No DNA ONE 0 Yes 0No DNA ONE 0 Ye s 0No DNA ONE d. Does the discharge bypass the waste management sys tem? (If yes, notify DWR) QYes 0No DNA ONE 2. Is there evidence of a past discharge from any part ofthe operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page I of3 \ 0 Yes 0 Yes ~No DNA ONE [Si_No DNA ONE 21412015 Continued •!Facility Number: ~-t7 V Waste Collection & Treatment I Date of Inspection: Cf-:IS:/7 I, 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): It' Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6 . Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~o 0 Yes 0No DNA ONE DNA ONE Structure 5 Structure 6 DYes ~o DNA ONE DYes ~o DNA QNE If any of questions 4-6 were answered yes, and tbe situation poses an immediate public bealtb or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures Jack 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 {2iNo D NA 0 NE 0 Yes j:&_No DNA 0 NE 0 Yes f8J No D NA 0 NE DYes [:giNo DNA ONE II. Is there evidence of incorrect land application? lfyes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): h/"tnu./~ / llr.h::r·.t,Yr-/ 13. Soil Type(s): A-u./ 1:;(./ Nt2,;f- 14. Do the receiving crops differ from those designated in the CAWMP? 15 . Does the receiving crop and/or land application site need improvement? 16 . Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box . Ow up Ochecklists D Design D Maps 0 Lease Agreements 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No DYes ~No 0 Yes (Zi.No DYes ~No DYes !53-No DYes (2iNo QYes ~No 00ther: DYes gj No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE O~A ONE DNA ONE DNA ONE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers D Weather Code 0 Rainfall Ostocking 0 Crop Yield 0120 Minute Inspections D Monthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes I~] No 0 NA 0 NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes I8J_ No 0 NA 0 NE Page2of3 114/2015 Continued '· il ;I Facility Number: g2: -V f/ !Date of Inspection: <J--1.£ /2 24. Did the facility fail to calibrate waste application equipment as required by the pennit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. DYes ~No DYes (g.No DNA ONE DNA ONE 0 Failure to complete annUal sludge survey 0Failure to develop a POA for sludge levels D Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance : 2 6 . Did the facility fail provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than nonnal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the pennit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Application Field D Lagoon/Storage Pond D Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? Reviewer/Inspector Name : Reviewer/Inspector Signature: Page3 of3 DYes [2gNo DYes 0fNo DYes [BNo DYes ~No DYes ~No DYes @No 0 Yes (&No DYes ~No 0 Yes 12}-No DNA O NE DNA ONE DNA ON E DNA ONE DNA ONE DNA ONE DNA ON E DNA ONE DNA ONE Phone: 9/t>-3{$-0.J.S( Date : /-=-;.r-.,!2lJ I 2 1/412015 Operation Review 0 Structure Evaluation Technical Assistance Reason for Visit: ~utioe 0 Complaint 0 Follow-u 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: II!J @{4 Arrival Time: lfJl>l p I Departure Time: lf!Y> P I County: Mlll Region: EP Farm Name: {t <>~l P-ef .e/'..t~~ -tf::.Z, Owner Email: Owner Name: Po'Yfl~ Pek~Of\ Phone: MaiUng Address: Physical Address: Facility Contact: Phone: Integ•••••: P~!J..e Certification Number: l.....;l:::...._~~BY'-+------ Onsite Representative: Certified Operator: Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts I. Is any discharge observed from any part of the operation? DYes ~DNA ONE Discharge orig inated at: D Structure 0 Application Field . a. Wa s the conveyance man-made? b. Did the discharge reach waters of the State? (If yes , notify DWR) 0 Other: DYes 0No ~A ONE DYes 0No ~A ONE c. What is the estimated volume that reached wateTS of the State (gallons)?· d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No ~NA ONE 2. ls there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page I of3 0 Yes 0 Yes ~· DNA ONE No DNA ONE 2/4/2015 Continued IFacility~umber: loate of Inspection:U @6 Waste CoUection & Treatment 4. rs storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a . If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): ~3~~-- 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e ., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes~ DNA ONE DYes 0No ~A ONE Structure 5 Structure6 . 0 Yes []!"No 0 NA 0 NE 0 Yes L]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 DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the s tructures lack adequate markers as r equired 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 Ep"No 0 NA 0 NE DYes ~o DNA ONE DYes ~o DNA ONE DYes DNA ONE 11. Is there evidence of incorrect land application? lfyes, check the appropriate box below. 0 Yes ~0 ~0 DNA ONE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12 . CropType(s): i3~vt.tulk._ 560 13. Soil Type(s) f1-,.. . Lr. JfJo 14 . Do the receiving crops differ from thOSdesignated in the CA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. 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. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropri ate box. OwuP 0checklists DYes 0 Yes 0 Yes DYes 0 Yes DNA ONE ONE ONE DNA ONE DNA ONE DYes ~o DNA ONE 0 Y es 12fNo DNA ONE D Des ign 0 Maps 0 Lease Agreements Oooer :--~------ 21. Does rec ord kee ping need improvement? If yes, check the appropriate box below. 0 Yes ~o D NA 0 NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code 0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and I " Rainfall Inspections 0 Sludge Survey 22. Did the facil ity fail to install and maintain a rain gauge? D Yes ~No 0 NA 0 NE DYes ~o DNA ONE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? Page 2 o/3 21412015 Continued I Facility ~umber: <f'l' -~~( jnate oflns2ection: !}...7 (Jt:-r 161 24. Did the facility fail to calibrate waste application equipment as required by the pennit? DYes ~ DNA ONE I ~ 25. Is the facility out of compliance with pennit conditions related to sludge? If yes, check DYes DNA ONE the appropriate box(es) below. 0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? DYes ~0 DNA ONE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes ~0 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 ~0 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 c::;}-No DNA ONE permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes ~No DNA ONE 0 Application Field 0 Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit or CA WMP? DYes g'No DNA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes GGo DNA ONE 34. Does the facility require a follow-up visit by the same agency? DYes 0""'No DNA ONE or a:ny . Reviewer/Inspector Name: Reviewer/Inspector Signature: Date : ~] ~f)q ({o Page 3 of3 21411015 0 Denied Access Date of Visit: lez?-15"J ArrivalTime:l J'7DD DepartureTime:l 1//oD I county: Z;;p'~ Region: F#O ~ . . ~L/ &"Mc1fP::"d-2 r.P"5§r,u Owner Email: Farm Name: Owner Name: Phone: Mailing Address: Physical Address: ----------------------------------------- Facility Contact: Onsite Representative: Certified Operator: Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Application F ield a. Was the conveyance man-made? D Other: b. Did the discharge reach waters of the State? (If yes, notify DWR) c . What is the estimated volume that reached waters of the State (gallons)? Phone: Integrator: ?/' c:-j~ Certification Number: /7 Y,f{LJ , Certification Number: Longitude: 0 Yes [2J1'Io DNA ONE .. DYes 0No DNA ONE DYes 0No DNA ONE d. Does the discharge bypass the waste management system? (If yes, notify DWR) QYes 0No DNA ONE 2. I s 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 rgNo DNA ONE ~0 DNA ONE 214/2014 Continued • ,. I ' I Facility Number: f'.?: -/.? /;1 Waste Collection & Treatment I Date of Inspection: 2:-z-/£ 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes 181-No 0 Yes 0 No DNA ONE DNA ONE Structure 5 Structure 6 0 Yes ..[29 No 0 NA 0 NE 0 Yes [8No 0 NA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR 7. Do any 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 [Sa No 0 Yes [;8No 0 Yes ~No DNA ONE DNA ONE DNA ONE 0 Yes [&_No 0 NA 0 NE ll.ls there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) D PAN D PAN > 10% or lO lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area 12 . Crop Type(s): Z3r.r~tt.Kb-/£Jv~/3"J 13. Soil Type(s): 4: t<. / L.. ..,-/ A/otf 14. Do the receiving crops differ from ~e ;esi~ated in the CA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination ? Page2of3 0 Yes 0(1 No 0 Yes ~No DNA ONE DNA ONE 0 Yes ~ No 0 NA 0 NE 0 Yes ~ No 0 NA 0 NE D Yes ~ No D NA 0 NE 0 Yes [3No DNA ONE DYes ~No DNA ONE Oother: DYes ~No 21412014 Continued , I Facility Number: • 24. Did the facility fail to calibrate waste application equipment as required by the permit? ~--' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. D Yes LRJ No D NA 0 NE D Yes U!SJ No D NA 0 NE 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 to provide documentation of an actively certified operator in charge? 27 . Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28 . Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes ~No DYes ~No DYes ~No DYes ~No DYes ~No DYes ~No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 0 Application Field D Lagoon/Storage Pond D Other: ----------------------- 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? Reviewer/Inspector Name : Reviewer/Inspector Signature: Page 3 of3 0 Yes ~No DYes ~No DYes [81 No DNA ONE DNA ONE DNA ONE Phone : 9/p-.t(J3-..35ZfD Date : 9-/-e:8?VS 11412014 Reason for Visit: 0 Other 0 Denied Access Date of Visit: Farm Name: I l,;tll?il( ArrivalTime:l t:oo I DepartureTime:l /tJ:Jo I county:>~ Region: e;e~ lf®aiJ {?T;;1rc=---ri-J~_!5 &!!( ~ Owner Email: Owner Name: gfP14!£ te hi:s r=:= Phone: Mailing Address: PbysicaiAddress: ---------------------------------------------------------------------------------- Facility Contact: 3endJ §.~.,._ Title: ..... ~"-~=-=-='11'-"'trC::;..;..,_ ____ _ Phone: 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: D Structure D Application Field D Other: a. Was the conveyance man-made? b. Did the d ischarge reach waters of the State? (If yes, no tify DWR) c. What is the estimated volume that reached waters of the State (gallons)? Integrator: ,Hq~ Certification Number: /Z~1 Certification Number: Longitude: DYes ~No DNA ONE DYes 0 No DNA ONE DYes 0No DNA ONE d . Does the discharge bypass the waste management system? (If yes , notify DWR ) DYes 0No DNA ONE 2. Is there evidence of a past discharge from any part of the operation ? 3. Were there any observabl e adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page I of.J DYes DYes I8J No DNA ONE ~N o DNA ONE 214/2014 Continued !Facility Number: 0-tdtl lnate oflnspedion: ,.Q?-2,?-If/l \ 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] Structure2 S tructure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): 12 Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any ofthe structures observed? (i.e., large trees, severe erosion, seepage, etc .) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DYes 0No DNA ONE DNA ONE Structure 5 Structure6 DYes ~No DNA ONE 0 Yes 12?1 No 0 NA 0 NE If any of questions 4-6 were answered yes, and tbe situation poses an immediate public bealtb or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the pennit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improveme nt? 0 Yes ~No 0 NA ONE D Yes t8l No 0 NA 0 NE DYes ~No DNA ONE 0 Yes j;gNo DNA 0 NE II. Is there evidence of incorrect land application ? Ifyes, ch eck the appropriate box below. 0 Yes (E._No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN > 10% or 10 lb s. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12.CropType(s): ~/Dvl:*~rr/ 13 . Soil Type(s): dt.t / L y /.No J: .-7 14. Do the receiving crops differ from tho se de signated in the C A WMP? 15. Does the receiving crop and/or land application site need improvement? 16 . Did the facility fail to sec ure and/or operate per the irrigation design or wettable acres d etermination? 17 . Does the facility lack adequate acreage for land application? 18. I s there a lack of properly op erating 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 th eCA WMP readily available? Ifyes, check the appropri ate box. 0 WUP 0Check lists 0 Design 0 Maps 0 Lease Agreements 21. Does record keeping need improvement? If yes, c heck the appropriate box below. 0 Yes .fZ9, No DYes (E:No DYes ~No 0 Yes jgJ No D Yes [l{No DYes ~No 0 Yes (g. No O other: 0 Yes ~No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code 0 Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and l" Rainfall Inspections 0 Sludge Survey 22 . Did the facility fail to install and maintain a rain gauge? 0 Yes ~No 0 NA 0 NE 23 . If selected, did the facility fai l to in stall and maintain rainbreak ers on irrigation equipment? Page2of3 0 Yes [gJ No 0 NA 0 N E 114/2014 Continued .IFacilityNumber: V -L/tl I IDateoflnspection: Q~-,C'/1 \ 24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes [gl No D NA D NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box( es) below. 0 Yes l.)aNo D NA 0 NE 0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. D id the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 0 Yes [8.No DYes ~No 0 Yes ~No 0 Yes liJNo DYes ~No 0 Yes ISJNo DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA O NE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Application Field 0 Lagoon/Storage Pond 0 Other: ----------------------- 32. Were any additional problems noted which cause non-compliance of the pennit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? Reviewer/Inspector Name: Revi e wer/Inspector Signature : Pagel of3 0 Yes ~No DYes ~No 0 Yes [&.No DNA ONE DNA ONE DNA O NE Phone: ~ y ?J-Ylo Date: p-:2:2-,..2-D//f 214/2014 Compliance Inspection 0 Operation Review 0 Structure Evaluation Reason for Visit: G-'ROi'itine 0 Complaint 0 Follow-up 0 Referral 0 Emergency Date of Visit: I L,.?.-'{:-' 13 I Arrival Time: I Cf:: 0 "D I Departure Time: It/ ', vl) I Coun~ Region: Ff? 0 FarmName: R~JJ ~~~ &111 ~ OwnerEmail: Owner Name: /5~) r~ f;:v_s ~ Phone: Mailing Address: Physical Address: ------------------------------------------- Facility Contact: ~ ~ ~ 0..,so----Title: f:i,)Wr~ ,_--Phone: Onsite Representative: Certified Operator: Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts I. Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Application Field a. Was the conveyance man-made? 0 Other: b . Did the discharge reach waters of the State? (If yes, notify DWQ) c . What is the estimated volume that reached waters of the State (gallons)? Integrator: _.:.,y;_~_z-.....:~:::;.....;Z;..;fr===7JIIIC-=;;;._----- Certification Number: /?~ Certification Number: Longitude: DYes j8}..No DNA O NE 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 adve rse impacts to the waters of the State other tha n from a discharge? Page 1 of3 DYes ,g] No DYes ~No DNA ONE DNA ONE 214110 11 Continued .. r::l F:-~c-::ili::-. ty---::-:Nu_m_b_e-r:--f??=---:-=--_ -~-9:.-:::---:J----, I Date of Inspection: ld:-'7:-/3 Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): /9 Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~o DNA ONE 0 Yes 0 No D NA 0 NE Structure 5 Structure 6 0 Yes ~No 0 NA 0 NE DYes ~No DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? · Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~No DNA ONE 0 Yes ~ No 0 NA 0 NE DYes ~No DNA ONE DYes ~No DNA ONE 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes [B-No 0 NA D NE D Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals {Cu, Zn, etc.) D PAN D PAN > I 0% or I 0 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area 12. Crop Type(s): Z:rr-mJ, 4u~.x:-u/ 13. Soil Type(s): A-u /L;7/ N'o;A: 14. Do the receiving crops differ from those designated in theCA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reguired Records & Documents I 9. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. 0WUP Ochecklists 0Design 0 Maps 0 Lease Agreements DYes ~0 DNA DYes ~No DNA DYes (idNo DNA DYes ~No DNA DYes ~No DNA DYes ~No DNA DYes IZJ. No DNA Oother: ONE ONE ONE ONE ONE ONE ONE 21. Does record keeping need improvement? lfyes, check the appropriate box below. 0 Yes ~No DNA ONE 0 Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers 0 Weather Code D Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections D Monthly and 1" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? D Yes .RJ No 0 NA D NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No 0 NA D NE Page2of3 2/412011 Continued \ ~·r-IF~ac~ili~.~~Nu-m~b-e-r:--~~~;L~----~7?Cf~)~j !Date of Inspection: /2-9'-13 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. D Yes 1:8] No 0 NA 0 NE DYes g_No DNA 0 NE 0 Failure to complete annual sludge survey QFailure 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 th e 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 p ermit? (i.e., discharge, freeboard problems, over-application) DYes ~No D NA ONE DYes ~No DNA ONE DYes (gNo DNA ONE DYes ~No DNA ONE DYes 18l..No D NA ONE DYes 5-No DNA ONE 31. Do subsurface tile drains exist at the facility ? If yes, check the appropriate box below. 0 Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------ 32. Were any additional problems noted which cause non-compliance of the permit 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? Rev iewer/I nspector Name: Reviewer/In spector Signature: Page3of3 DYes ua_No DNA ONE D Yes gNo DNA ONE DYes ~0 DNA ONE Phone: ~--fJT--:J'Juo Date: /.?2--'7--,?Dd 11412011 f \ I ·~~~~~~~~~~~~~~==~ ompliance Inspection Operation Review 0 Structure Evaluation Reason for Visit: ~ne 0 Complaint 0 Follow-up 0 Referral 0 Erne ency Date of Visit: I 7=-U fA-Arrival Time: I//.' JfS I Departure Time: J2! VZ' I County~~ Region: .F;KiJ Farm Name: J<o,_&-tJ f::&/3 tr--' c--3tez:, @/J'J1 ~wner Email: -------------- Owner Name: ~a-t/ &·&1'u--' Phone: Mailing Address: PbysicalAddr~s : ---------------------------------------------------------------------------------- Facility Contact: ~ .t;;z:;;;.r-Title: A</n ,...,......-- Onsite Repr~entative: Certified Operator: Back-up Operator: Location of Farm: Latitude: Disc harges and Stream Impacts 1. Is an y di scharge observed from any part of the operation? Discharge originated at: D Structure 0 Application Field a. Was the conveyance man-made? D Other: b. Did the discharge reach waters of the State? (Ifyes, notify DWQ) c. What is the estimated vo lum e that reached waters of the State {gallons)? Pbone: Integrator: &r~ Certification Number: .~-1.&-Z .... ~::;....r::."r_~....!....----- Certification Number: Longitude: DYes 18} No DNA ONE DYes 0No DNA ONE 0 Yes 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 othe r than from a discharge? Page 1 of3 DYes DYes ~No DNA ONE ~No DNA ONE 2/4/2011 Continued ·!Facility Number: ( -(,~ ' !Date of Inspection: i ' Waste Collection & Treatment \ 4. Is storage capacity (structura] plus storm storage plus heavy rainfa11) less than adequate? DYes [gNo DNA ONE a. If yes, is waste level into the structural freeboard? DYes D No 0 NA D NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? DYes ~No DNA ONE (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a D Yes ~No D NA D NE waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? X. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~No DNA ONE D Yes f2:J No 0 NA D NE DYes ~No DNA ONE DYes ~No 0 NA 0 NE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~No D NA 0 NE 0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area I2.CropType(s): Z,r~ /lt)v-~z-c~J 13. Soil Type(s): Au /L '/ /No /1- 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes. check the appropriate box. OwuP 0Checklists 0 Design 0 Maps 0 Lease Agreements DYes ~No 0 Yes ~No DYes [81 No DYes ~No DYes ~No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 0 Yes ~No DNA 0 NE 0 Yes ~No D NA 0 NE Oother:. ________ _ 21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes ~No D NA 0 NE 0 Waste Application D Weekly Freeboard D Waste Analysis D Soi I Analysis 0 Waste Transfers 0 Weather Code 0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? Page 2 ll/3 DYes ~No 0 NA 0 NE DYes ~No DNA 0 NE 214/2011 Continued ., ' ''!Facility Number: #?? -?!fl I Date of Inspection: 7-t..:z--12-----1 ' 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes f29._No DNA ONE the appropriate box(cs) below. 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 bdow. 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? Reviewer/Inspector Name: Reviewer/Inspector Signature: Page3 of3 DYes ~No DNA ONE DYes ~No DNA ONE DYes [81 No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes jgNo DNA ONE DYes ~No DNA ONE DYes .8] No DNA ONE DYes ~No DNA ONE Phone : ~J3i1D Date : 7-D;?&/~ 21412011 ·, ompliance Inspection Operation Review 0 Structure Evaluation Reason for Visit: @-ROUtine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Denied Access Date of Visit: Farm Name: I ?:-/c//1 Arrival Time:Q! D () I Departure Time:! fl: ol) I County:~~.:fP:'--Region: z::;e a 'K v#W.lJ p,_ kC-s' D-f/: )oa f w~?-owner Email: Owner Name: btPtta IJ. TeJer~ o~ Phone: Mailing Address: Physical Address: ------------------------------------------- Facility Contact: Onsite Representative: Certified Operator: Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 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: f/' r.;1~ Certification Number: /~ Certification Number: Longitude: DYes _g) No DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No DNA ONE 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page 1 of3 DYes DYes g) No DNA ONE ~No DNA ONE 21412011 Continued • !Facility Number: g;;z. -/!J9:/ Waste Collection & Treatment I nate of Inspection: '8=-J ~II '\ 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! Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): t't Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 0 Yes ~No DNA 0 NE 0 Yes ~No 0 NA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~No 0 Yes 12J.No DYes ~No DNA ONE DNA ONE DNA ONE 0 Yes Ji') No 0 NA 0 NE 11. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. 0 Yes !29 No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lb s . 0 Total Phosphorus D Failure to In corporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area 12.CropType(s): ~~. /pi/Y'~~/ 13. Soil Type(s): /tu / L-y /N&d: 14. Do the receiving crops differ rfom t~ose designated in theCA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check the appropriate box. DYes ~No DNA ONE DYes ~No DNA ONE 0 Yes ~No DNA ONE 0 Yes ~No DNA ONE 0 Yes ~0 DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE OwUP 0Checklists 0 Design D Maps D Lease Agreements 00ther: _________ _ 21. Does record keeping need improvement? Jfyes, check the appropriate box below. 0 Yes ~No 0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Rainfall 0 Stocking 0 Crop Yield D 120 Minute In spections D Monthly and 1" Rainfall Inspections 22. Did the fa cility fail to install and maintain a rain gauge? 23 . If selected, did the facility fail to ins tall and maintain rainbrc akers on irrigation equipment? Page 1 of3 DYes ~No DYes pg No DNA ONE D Weather Code D Sludge Survey DNA ONE DNA ONE 11411011 Continued • !Facility Number: Jt2 -(; ?I I I nate oflnspection: 9-"-/7-¢12/11 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box( es) below. DYes ~No DNA ONE 0 Yes (gLNo 0 NA 0 NE 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? 2 7. 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. 0 Yes [81 No 0 Yes ria No DNA ONE DNA ONE DYes ®_No DNA ONE 0 Yes IRI.No DNA 0 NE 30. Did the facility fail to notify the Regional Office of emergency situations as required by the 0 Yes l8J No D NA 0 NE permit? (i.e., discharge, freeboard problems, over-application) rxAYes ~o,. D NA 0 NE 31. Do subsurface tile drains exist at the facility? Ifyes, check the appropriate box below. ~ ~NO IS2J_ Application Field D Lagoon/Storage Pond D Other: ___________ _ 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? Reviewer/Inspecto r Name : Reviewer/In spector Sig nature : Page3 of3 DYes jgl_No DNA ONE ~No ONE Phone : Date: i? I Z -;;zoJ I 21411011 Type of Visit ~71iance Inspection 0 Operation Revi ew 0 Structure Evaluation 0 Technical Assistance Reason for Vi sit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access Date of Visit: ~ /0 I Arri\lal Time: I 3 ! ~() Departure Time: I £/;.3 0 I County: .:!:!.~~fll.:::=:.... Region: FE i) Farm Name: :lf:R1,1) t?f/;rf'lt""""= rL.SO?J•) ,tivM ~ Owner Email:------------- Owner Name: )<..r:rn..JJ ft:: ~rfr:;r---Phone: Mailing Address: ----------------------------------------- Physical Address:----------------------------------------- Facility Contact: -+-AL..~~,d,/""-""'-'----'B:--~..;...'7;;-=-ft',..:...:r.i~"'----Title: ev,~r PhoneNo: _________ _ Onsite Representative: -----~"""~"'""'--'=------------Integrator:)"": C.:S~ Certified Operator: #~ -----------Operator Certification Number: ------- Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts 1. Is any di scharge observed from any part of the operation? DYes IS No DNA ONE Discharge originated at: D Structure D Application Field D Other a. Was the conveyance man -made? b. Did the discharge reach waters of the State? (If yes , notifY DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notifY DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of th e State other than from a discharge? Page 1 of 3 DYes 0No DNA ONE DYes 0No D NA ONE I DYes 0No DNA ONE DYes ~No DNA ONE DYes UWo DNA ONE 12128104 Continued IFacilityNumber: v-tz<tl I Date of Inspection I q.pl3-/0I Waste Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes i?JNo DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 Identifier:---------------------------------------- Spillway?: Designed Freeboard (in): C 9' Observed Freeboard (in): '1,3 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes [g.No DNA ONE DYes PJ: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 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. Arc there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ~No DNA ONE DYes t&No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE 11. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes 1:3-No DNA D NE D Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into BareSoil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12 . Crop type(s) :Dr:;,~ lerca'JTYj 13. Soil type(s) th~ / [ v /tJ{)Jr 14. Do the receiving cr:p: di£ ~om those designated in the CAWMP? DYes 5lNo DNA ONE 15. Does the receiving crop and/or land application site need improvement? DYes 51' No DNA ONE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes ~NoD NA 0 NE 17. Does the facility lack adequate acreage for land application? DYes ~No DNA ONE 18. Is there a lack of properly operating waste application equipment? DYes ti)No DNA ONE Reviewer/Inspector Name Reviewer/Inspector Signature: Phone: ~~~~~~~~~ Date: Pa ge 2 o/3 Continued 1 • j Facility Number: ?2-:-(,'7 'I Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No DNA ONE DYes ~No DNA ONE DYes )SJ..No 0 NA 0 NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification D Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 24. Did the facility fail to calibrate waste application equipment as required by the pennit? 25. Did the facility fail to conduct a sludge survey as required by the permit? 26. Did the facility fail to have an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? If yes , contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by General Permit? (ie/ discharge , freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 33. Does facility require a follow-up visit by same agency? DYes laNo DNA ONE DYes [!No DNA ONE DYes mNo DNA ONE DYes !»No DNA ONE DYes ~No DNA ONE DYes 12!No DNA ONE DYes fl!No DNA ONE DYes {2No DNA ONE DYes 00No DNA ONE DYes j2g.No DNA ONE DYes !SlNo DNA ONE DYes 181-No DNA ONE Page 3 of3 11128/04 ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit @1fcilitine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access DateofVisit: 1'[-9-oi'-Arrival Time: I I :oo I DepartureTime: 13 IOD I County:~'ft:T-Region: £1?1) Farm Name: Z'Daed.J & kc5{)1'1. rtSna f Far' m. ~ Owner Email: ------------ Owner Name: '6 fn1a.QJ f t::ler.{ tl ""-Phone: Mailing Address: ------------------------------------------ Physical Address:--------------------------------------------- Facility Contact: K fm.a.R) fcV"";r;so-J"\...._ Title: __________ _ PhoneNo: ___________ ___ Integrator: ,'itr~¥ Onsite Representative: ---~'-e=:-=-c---.~=:::::!::::----------- Certified Operator: ----...:_3=-:.,.....,=-:.....='==-------------Operator Certification Number: -------- Back-up Operator: ----------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Strea m Impa cts I. Is any d ischarge obse rv ed fr om a ny part of th e operation? DYes ~-No Di sc harge originated at: D Structure D Application Field D Other a . Was the co nveya nce m an-made? DYes 0 No b. Did the di scharge reac h wate rs ofthe State? (If ye s, notify DWQ) DYes 0 No c. Wh at is the est im a te d vo lume that reached waters of th e State (gallons)? d. Doe s di sc harge byp ass the w aste management system? (I f yes, noti fy DWQ) DYes 0 No 2 . Is th ere evidence of a past di sc harge f rom any part of the operati on? 3. W ere there an y ad verse imp acts or potenti al advers e im pacts to the Waters o f th e State othe r tha n fro m a disc harge? DYes ~No DYes ~N o 11128/04 D N A ONE D N A ONE DNA ONE DNA ONE DNA ONE D NA ONE Continued I Facility Number:??=-tzV I Oltte of Inspection I 9:9-09l ~Collection & Treatment 4 . Is storage capacity (structural plus storm storage plus heavy rainfall) Jess than adequate? a . [f yes, is waste level into the structural freeboard? Stn1cturc I Stn1cture 2 SmJcture 3 Stn1 c tun.: 4 DYes [SlNo D NA ONE DYes 0No DNA ONE S 1ruc tun.: 5 Sllllctur.: 6 ldentifi\!r: ------------------------------------ Spillway?: Designed Freeboard (in): __ __,I....,CJ,;..._ __ ----------------------------------- Observed Freeboard tin): ---67-~V.A.--------------------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? (iellarge trees, severe erosion, seepage, etc.) DYes IJaNo DNA ONE 6. Are there stnlctures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes j&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? 00. Yes 0No DNA ONE 8. Do any of the stuctures lack adequate markers as required by the permit? DYes !&No DNA ONE (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require DYes fXNo DNA ONE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need 0 Yes ~No 0 NA D NE maintenance/improvement? 11 . Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes [g.No DNA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN > 10% or 10 Jbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area 12. Croptype(s) Anuz~ levrr-.-sr-c/ 13. So;l type(s) A-t., I;?.; I x1a A- 14. Do the receiving crops di er from those des1gnated rn the CA WMP? 0 Yes f)a No 0 NA D NE 15. Does the receiving crop and/or land application site need improvement? 0 Yes 6a No 0 NA 0 NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'iO Yes [Sa No 0 NA 0 NE .17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? DYes ~No DNA ONE DYes ~No DNA ONE Commeob (mer to question#): Explaio any YES answen and/or aoy recommendations or any other comments. Use drawings offadlity to better explaio situation (use additional pages as nec:essary): e3 {bn-t;:~ .... f- /P'DI"/G~ ~..fe,.-).{1--~ tx-f_;,, ....-.... Reviewer/Inspector Name ¢"i-~ &~7:;::_--Phone: qtD-1(33-3!00 Reviewer/Inspector Signature: z'Z;~ ~·/I ~ Date: :t ct-o:t ,. 11128/04 Continued II I [Facility Number: ~ -tJt/ I Required Records & Documents Date of Inspection l fiott-1 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes , check the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other DYes lXNo DNA ONE 0 Yes j5a No 0 NA 0 NE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes f.2lNo 0 NA 0 NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification 0 RainfaH 0 Stocldng 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 ~No DNA ONE .23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No DNA ONE 24. D id the facility fail to calibrate waste application equipment as required by the permit? DYes lfaNo D NA 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 ljiNo DNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CA WMP? DYes ~No DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes ~No D NA 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 K1 No DNA ONE If yes, contact a regional Air Quality representative immediately 3 I. D id the facility fail to notify the regional office of emergency situations as required by DYes .RJNo 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 -WJNo DNA ONE 33. Does facility require a follow-up visit by same agency? DYes ~0 DNA ONE 12128104 ,_ \ ompliance Inspection 0 Operation Review 0 Structure Evaluation Reason for Visit ~ine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 other D Denied Access DateofVisit: I~M Arriva1Time:I?:3V I DepartureTime: 1/tJ!:S iJ I County;....~~,-.. Region :~ '0 Farm Name: l?t>vua/J. 'fe1:;-.srr-::J:S~·~ f7;L;'""" 2--Owner Email:------------ Owner Name: /<,"'t:rn2-IJ ?crfe;~ D--Phone: Mailing Address: ----------------------------------------- Physical Address:-----..,------------------------------------- Facility Contact: ~,( &1!=~~ Title: ----------- Phone No: _________ _ Onsite Representative: _ ... ./'-.;:;~--=--==------------Integrator: ~ z--~ Certified Operator: ___ S~tt:Jt---=-""'-.... --=;....._------------Operator Certification Number: -------- Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD 'D " Longitude: D OD'D " Di sc harges & Stream Impacts I . Is any discharge observed from any part of th e operation? DYes ~o DNA ONE Discharge origina ted at 0 Structure D Application Field 0 Other a. Was the conveyance man-made? DYes 0No DNA ONE b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No DNA ONE c . What is the estimated volume that reached waters of the State (ga ll ons)? d. Does 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 adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Page I of 3 DYes QlNo DYes Di.No 12/28104 DNA ONE DNA ONE Continued \ ~ I Facility NumberQ -G/t( I Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 Identifier: ------ Spillway?: DYes 1!1-No DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 Designed Freeboard (in): __ £-e.:-'9::-------------------------------------- Observed Freeboard (in): _ _..3""-,_} __ _ 5. Are there any immediate threats to the integrity of any ofthe structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DNA ONE DYes ~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? !)§.Yes 0 No 0 NA D NE 8. Do any of the stuctures lack adequate markers as required by the pennit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. 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 5aNo DNA ONE DYes ~No DNA ONE 0 Yes 18-No 0 NA 0 NE 11. Is there evidence of incorrect application? lfyes, check the appropriate box below. 0 Yes E_No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metal s (Cu, Zn , etc.) 0 PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorp orate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outsid e o f Area 12. Croptype(s) br~ fvv-crfte,e-) 13. Soil type(s) z{-u / L v / Nok 14. Do the receiving crops d:tfer tOm t:se:signated in the CAWMP? DYes iQJNo 0 NA 0 NE 15. Does the receiving crop and/or land application site need improvement? D Yes ~No D NA 0 NE I 6. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?O Yes rzkNo D NA 0 NE 17. Does the facility lack adequate acreage for land application? 0 Yes ~o DNA 0 NE 18. Is there a lack of properly operating waste application equipment? 0 Yes ~o 0 NA 0 N E Reviewer/Inspector Name Reviewer/Inspector Signature: Pagel of 3 Date: 11128104 \ ' I Facility Number:~ kfl Required Records & Documents Date of Inspection I 7'2~bl" 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check the appropirate box. 0 WUP 0 Checklists 0 Design D Maps 0 Other 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes OINo DNA ONE DYes ~No DNA ONE DYes liNo DNA ONE D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification D Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes IE; No DNA ONE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes S.No DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes g_No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes l)g_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 or CAWMP? DYes ~0 DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes f23.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 IE No DNA ONE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify th e regional office of emergency situations as required by DYes General Permit? (ie/ discharge, freeboard problems, over application) ~No DNA ON E 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 ~ . ~...,-, ... ~' . ~ ::.. ·.· ... - Pagel of 3 12128104 I Facility Number I ~ H 4 9/ II ~on of Water Quality sqt-c r-p:r~ 0 Division of Soil and Water Conservation ~ v- 0 Other Agency Type of Visit Q.eompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ~ 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: ~/f Arrival Time: I 11':'/6 I Departure Time: II/! 0 0 I Count~~ Region :~{) . I ~ -,----- farm Name: t?aru:ziJ &fer.>tra---pl-:~tJ-s..f @rm. Owner Email: ------------ Phone: Owner Name: R<ii:C?df &.?;;"r:~ ~ Mailing Address: //(/£ !(} /J'/f= G-; ~~ eJ.u,.~J._ 7d L?/;~ ;~e_?j-3~ Physical Address:---------------------------------------- Facility Contact: ,G--nPtJ b JfY.s~itle : ----------PhoneNo: ________ _ Onsite Representative: _ ... ..&~~....;....;;;;;;.;;;=;;;;.._----------- Certified Operator:----~=.;...:;....=------------- Integrator: ~~ 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 Current · Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population ID Wean to Finish I I 10 Layer 0 Wean to Feeder 0 Non-Layer 0 Dairy Cow ' ' 0 Dairy Calf ' I ! BFeeder to Finish '1'110 3K'VO 0 Farrow to Wean 0 Farrow to Feeder 0 Farrow to Finish 0 Gilts 0 Boars - 0 Dairy Heifer i 0 Dry Cow ' 0 Non-Dairy 0 Beef Stockel 0 Beef Feeder : 0 Beef Brood Cow .I --·-~-·· ~··-·-. Dry Poultry 0 Layers 0 Non-Layers 0 Pullets 0Turkeys Other 0 Turkey Poults 0 Other Number of Structures: QJ. ID O ther Discharges & Stream Impacts I . Is any di scharge observed from any part of the operation? D Yes ®No DNA ONE Discharge originated at: D Structure 0 Application Field D Other a. Was the conveyance man-made? D Yes 0No DNA ONE b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0 No DNA ONE c. What is the estimated volume that reached waters of the State (gallons)? I d . Does di sc harge bypass the waste management system? (If yes, not ify DWQ) 2 . Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impac ts or potential adverse impacts to the Wat ers of the State other than from a discharge? DYes 0 No DYes f&[No DYes lXNo 12128104 DNA O NE DNA O NE D NA O NE Continued ' !Facility Number:n-b't/1 Date oflnspection gb--»-:47 Waste Collection & Treatment 4 . Is storage capacity (structural plus stonn storage plus heavy rainfall) Jess than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes ~o DNA ONE DYes 0No DNA ONE StructureS Structure 6 Identifier:----------------------------------------- Spillway?: Designed Freeboard(in): ___ /~9--------------------------------------- 0bserved Freeboard (in): __ .... r~2~-------------------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? DYes J8.No DNA ONE (ie/ large trees, severe erosion , seepage, etc .) 6. Are there structures on-site which are not properly addressed and/or managed DYes blNo DNA ONE through a waste management or closure plan ? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any ofthe structures need maintenance or improvement? 8. Do any of the stuctures lack adequate markers as required by the pennit? (Not applicable to roofed pits, dry stacks a nd/or wet stacks) 9 . Does any part of the waste management system other than the waste structures require ma intenance or improvement ? Was te Application I 0. Are there any required buffers , setback s, or compliance alternatives that need maintenance/improvem ent? 18l..Yes 0No DNA ONE DYes ~No DNA ONE 0 Yes r&:No DNA 0 NE DYes ~No DNA ONE 11. Is there evidence of incorrect applicati on ? If yes, check the appropriate box below . 0 Yes .1&1-Jo 0 NA 0 NE 0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn , etc.) D PAN 0 PAN > 10% or 10 lb s 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind D rift 0 Application Outside of Area 12 . Crop type(s) $cypy~ /pe.,....,-=1,e:J 13 . Soil type(s) .4=" /1- 7 : ,/ yo,f. 14 . Do the receivi ng crops differ from those designated in the CAWMP? 0 Yes l>lNo 0 NA 0 NE I 5 . Does the receiving cro p and/or land application site need improvemen t? 0 Yes ~o 0 NA 0 NE 16. Did the facility fail to sec ure and/or ope rate per the irrigation des ign or wettable acre detcnnination?D Yes aNo 0 NA 0 NE 17 . Does the facility lack adequate acreage for land application? 18. Is there a lack of properl y operating waste application equipment? DYes £l_No DNA ONE DYes l)a_No DNA ONE Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. Use drawings of facility to better explain situations. (use additional pages as necessary): ret~.-/<Ar/c~~......,k-$, ..... - -... Reviewer/Inspector Name ..o-~ b-Y-t/"5~ Phone: 9[.(2-1(35' 3'3010 Reviewer/Inspector Signature: .,A.L_ -~~/ 8:---¢2 -,fl-ot:; 2 ~ Date: • , ~ 11/28104 Continued ' \ I Facility Number:0:--~9-/1 Date of Inspection ldt"-b-P? Required Records & Documents 19. Did the facility fail to ha ve Certificate of Coverage & Pennit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropirate box. D WUP 0 Checklists 0 Design 0 Maps D Other DYes 5-No DNA ONE DYes !&No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes f:2tNo DNA D NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking 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? DYes ~No DNA ONE 23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~No DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes 00No 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 Ill No DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes I81No 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 QlNo DNA ONE If yes, contact a rebrional 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? D Yes ~No DNA ONE 33 . Does facility require a follow-up visit by same agency? D Yes ~No DNA ONE Additional Comments and/or Drawings: .... 1-- 1--... 12/28/04 ' '~ ,I ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ~ine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Region: t:z:O. Dat e of Vis it: lk7Jb-D4 Arrival Timed/a~ t>Oj Departure Ti me:~ C oun ty:~~ Farm Name: ,l?tr:a-LI &~'5{) 1'1. crSt)/f.,.S /iirm-? Owner E mail: ------------ Owne r Name: ./?.<'Pflt« Lj ,!?,-fC'l: Sflrt Pbon e: M a iling Address: ---------------------------------------- Phys ical Address:------.,.------------------------------------ Facility Contact: t{'lJ!Ulh/ &"«1.6,.._Title: ---------Phone No: _________ __ Integrato r : ~~~ Ons ite R epresentative: __ z:~~~...;;...:::.........C'------------- C ertified Operator: ----Zo:::.....o;a&1a.::..o::.J ... d=-...,..-------------Operator Certification Number: -......:...------ Back-up Operator: --------------------Back-up Certification Number : L ocation of Farm: Latitude: D OD 'D " Longitude: Discharges & Stre am Impacts 1. Is any d isch arge observed from any part of the operati on? D Yes J;f1 No D NA O NE D ischarge originated at : 0 Structure 0 Appli cation Field 0 Other a. Was the conveyance man-made? b. Did th e discharge reach waters o fthe State? (If yes, noti fY DW Q) c. What is the estimated volume that re ached wa ters of the S tate (gallon s)? d . Does disc harge bypass the waste management system? (If yes, notify DWQ) 2. Is t here evide nce of a past di sc harge from a ny part of the o perat ion? 3. Were there any adverse impacts or potenti a l a dverse impacts to the Wa ters of th e State o ther than from a disc harge? Page 1 of3 ·'· ~. DYes [(No D NA O NE DYes (!_No D NA O NE D Yes i!t.No D NA O NE D Yes Bl No D N A O NE D Yes _Dg No D NA O NE 12128/04 Continued \.. ' l Facility Number: 82:-W/1 Date oflnspection [ b -J;('tr=p~ \, Waste Collection & Treatment DYes I?JNo DNA ONE DYes ~No DNA ONE 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. If yes. is waste level into the structural freeboard? .,strUcture l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier:--------------------------------------- Spillway?: Designed Freeboard (in): :w.._/?: Observed Freeboard (in): ;£z ...... 5. Are there any immediate threats to the integrity of any ofthe structures observed? (ie/large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes C8:No 0 NA 0 NE DYes f2iNo 0 NA D NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? ~Yes 0No DNA ONE DYes ~No DNA ONE DYes ~o DNA ONE DYes J)l_No DNA D NE II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes l2i No 0 NA D NE D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs 0 Total Phosphorus 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) :($-rl'mJa Gr'a-"+.r= /..?)n,dwaJa G-r-4'7-r' 13. Soil type(s) 4-:u. /;lotf: /Lv 14. Do the receiving crops differ from those de:ign?edin theCA WMP? 15. Does the receiving crop and/or land application site need improvement? DYes ~No DNA ONE 0 Yes !):No 0 NA 0 NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre deterrnination!O Yes qtNo DNA 0 NE 17. Does the facility lack adequate acreage for land application? 0 Yes ~No 0 NA D NE 18. Is there a lack of properly operating waste application equipment? 0 Yes ~o DNA 0 NE Reviewer/Inspector Name Reviewer/Inspector Signature: Phone: 9a'-2'J'"_T:3:>Y..;2.. Date: 6 -plt, -ZJ fa 11/28104 Continued ' ;,. I Facility Number: g;;...-b <ftl r , Required Records & Documents Date oflnspection I b ';;!lt.-'f~ 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. 0 WUP 0 Checklists D Design 0 Maps D Other DYes lJaNo DNA ONE DYes m.No DNA ONE I 21 . Does record keeping need improvement? If yes, check the appropriate box below. DYes ~o 0 NA D NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers 0 Annual Certification D Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and I" Rain Inspections D Weather Code 22 . Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE 23 . If selected, did the facility fail 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 I2J 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 18-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 ~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 If yes, contact a regional Air Quality representative immediately t&_No DNA ONE 31 . Did the facility fail to notify the regional office of emergency situations as required by DYes 8l.No DNA ONE General Permit? (ie/ di scharge, freeboard problems, over appli cation) 32. Did Reviewer/In spector fai l to discuss review/inspection with an on-site representative? DYes a No DNA ONE 33. Does facility require a follow-up visit by same agency? DYes i)lNo DNA ONE .. · Page3of3 12128104 llllliliE!~--~ 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 D Denied Access Dateof\'isit: IS/.11 /Qil ArrivaiTimc :l /0 .'/" I Departure Time:! L ---~~County : 5a""(UON Region : Fgp Farm Name: r.:t)r!.,J & Pe.~="-'0.., ~ .SoJ-O..S ~=:........ tr .::l Owner Email: -------------- Phon e: (S IO) S'!t3-5.3' I Owner Name: R o r\ 4.\ JL ___:P.~c.llio+~:..~~c:...;;..J:Y...3o>~..aWII!IL _____ _ !\tailing Address: Physical Address:----------------------------------------- Facility Contact: --------------Title: -----------PhoneNo: _________ _ Onsitc Representative: ------------------Integrator: __ ,.Lp----!:,._.C.~•-+.Lilo~...;,~c~---.....:...---- Certified Operator: __ .t.,R~oLJn~c._\ucRZio....--_ _..f?_....~ .... _..±,~~c. .... rr....·•a.co~e-)~>oL----0 per a tor Ce rtlfication Number: _..;.;:}=----O....:::;l::..:..;:'=-='~- Back-up Operator: _ _.l<.;;:uo~;L;"'n..o~•L(J..Jo(~~--_....:.P.....:<-r+§.CI;..C,C--..JY~-'.II'Dut.l..__ ___ _ Back-up Certification Number: Location of Farm: Latitude: D OD 'D " Longitude: D OD'D" Design Current Capacity Population Design Current Capacity Population Swine Cattle Wet Poultry Design Current, Capacity Population ID Wean to Finish 0 Wean to Feeder 0 DairvCow i 0 Dairy Calf i 10 layer I I IE Feeder to Finish 1/l/ ID ~1/C./ 0 Farrow to Wean 0 Farrow to Feeder D Farrow to Finish D Gilts 0 Boars --· ··~· -- 0 Dairv Heife1 I ODrvCow I D Non-Dairv i D Beef Stockel I 0 Beef Feeder I D Beef Brood Co\\ I ~·--· . -·----·· - Dry Poultry 0 l ayers 0 Non-lavers 0 Pullets D Turkevs Other 0 Turkey Poults 0 Other . ----·· ···-· Number of Structures: 1_1 _ .J!. ~ ,, . [D Other Discharges & Stream Impacts I . Is any discharge observed from any pan of the operation? DYes ij]No DNA ONE Discharge originated at: D Structure D Application Field D Other a. Was the conveyance man-made? DYes 0No DNA ONE b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No DNA ONE c. What is the estim ated \'Oiume that reached waters of the State (ga ll ons)? I 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 potentia l adverse impacts to the Waters of the State other than from a discharge? DYes DNo DYes lXI No DYes 00No 12128/04 DNA ONE DNA ONE DNA ONE Continued ( '--" Date of Inspection I G ~~~lAd Wasie Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard ? Structure I Structure 2 Structure 3 Structure 4 0 Yes (}I No 0 NA 0 NE DYes 0No DNA ONE Structure 5 Structure 6 Identifier: _---.:.d.=;.;;.::;_·:::__·_·,..;_,_-------------------------------- Spillway'!: Designed F reeboard (in): ---==/~9_/;..;.,'------_~ .... _- 0bserved Freeboard (in): f3~ ''-~ ~ /~o /'U•'---------------------- 5. Are the re any immediate threats to the integrity of any of the structures observed? DYes ~No DNA ONE (ie/ large trees, severe erosion, seepage, etc .) 6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public bealtb 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 was te management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? 00 Yes D No D NA 0 NE 0 Yes ~No DNA ONE DYes 00No DNA ONE 0 Yes !;XI No DNA 0 NE 11. Is there evidence of incorrect application ? If yes, check the appropriate box below. 0 Yes Iii No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu. Zn, etc.) 0 PAN 0 PAN > 10% or 10 lbs 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12 . Croptype(s) __ ~~~,~~~~~»~JA~~H~~~w~,--cA~Le~z-~=~J~e~,~r~~~cJQ~~,~o~~~~~s~c~------------------------------ 13 . Soil type(s) tfl,. 1 Ly, N_, A 14. Do the receiving crops differ from those designated in theCA WMP? 15 . Does the receiving crop and/or land application site need improvement? 0 Yes [il No DYes ~No 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre de termi nation~ 0 Yes []I No 17. Does the facility lack adequate acreage for land application? 18 . Is there a lack of properly operating waste application equipment? Ja1 DOAJ DYes R2)No 0 Yes IXJ No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE . I" .So i I o ,... h i J e~+ .. lo lcJ l ~ v.e.,-c.Ao:c"'-lv<. c..uv~~ Reviewer/Inspector Name Reviewer/Inspector Signature: Phone: Date: 12128104 Continued .. . I Facility Number: ~ .,2 -(. Cj J I Required Records & Documents Dat{' of Inspection [§)o]ffATj 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? If yes, check the appropirate box. D WUP D Checklists D Design D Maps 0 Other 21. Does record keeping need improvement? Ifyes, check the appropriate box below. DYes li!No DNA ONE DYes ~No DNA ONE ljJ Yes Iii No DNA 0 NE D Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification 0 Rainfall D Stocking 0' Crop Yield D 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? lXI Yes 0No DNA ONE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes li]No DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes liJ No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes liJNo DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes lj!No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 0No DNA MINE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes [ENo 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 [iJNo DNA ONE 30. At the time of the inspection did the facility pose an odor or air quality concern? DYes CENo DNA ONE lfyes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by DYes General Permit? (ie/ discharge, freeboard problems, over application) ~No DNA ONE 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE 33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE , .... ~ qo ' ~ .... ~: .. ~........ ~ t 0-s. '•+-' H-olf -o'-1, * '. 1212&104