310214_Inspection_20190910

Division of Water Resources
Facility°N,umber � -' O Division of Soil and -Water Conservation -
O OtherAgency
Type of Visit: QfCompliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: 61 kim I Owner Email:
Owner Name: Wk,16^ Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
a Designs Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder 0 D
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other ' "-
Title: Phone:
Integrator:
Latitude:
Certification Number:
Certification Number:
Longitude:
%° Design Current
Wet Poultry Capacity Pop -
La er
Non -La er
Design _ Current ,
Other
Poults
■
Design-' Current
Cattle Capacity. Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any partof the operation?
Oes O No
ElNA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
0 No
❑ NA`
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
U-ITo ,
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
P,4o
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 2/4h01 S Continued

Facili Number: -1, jDate of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[:]No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:_
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3Q
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
vo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
To
❑ NA
❑ 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 DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
Eg<o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[],<
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
B<o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[ No
❑ NA
❑ NE
mam enance or improvemen .
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes <o
❑ Yes Vo
ElYes
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ Yes ®'No ❑ NA ❑ NE
❑ Yes ❑N—o ❑ NA ❑ NE
[:]Yes E No ❑ NA ❑ NE
❑ Yes To ❑ NA ❑ NE
❑ WUP ❑ Checklists ❑ Design [:]Maps ❑ Lease Agreements ❑ Other:
21. Dyes record keeping need improvement? If yes, check th propriate box below. ®�s ❑ No ❑ NA ❑ NE
Waste Application ❑ Weekly Freeboard Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall InspectioZ11110PIE]
Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [:]No 5 IA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes © o
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ 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.
❑ Application Field ❑ Lagoon/Storage Pond ❑ 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?
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
Ello
❑ NA
❑ NE
❑ Yes
❑ No
®.lam
❑ NE
❑ Yes
®�o
❑ NA
❑ NE
❑ Yes [9,Nz ❑ NA ❑ NE
❑ Yes Quo ❑ NA ❑ NE
❑ Yes E 5o ❑ NA ❑ NE
❑ Yes ©<!o ❑ NA ❑ NE
❑ Yes ©No ❑ NA ❑ NE
❑ Yes ��eo ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).ktl,? //�
I A
� ( �1 �` � 7 _l Iv3 y a, 3 y C.✓
-f�--/o Aug.
PN
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
ad er
Ao 46,97 tLcj-
S� 0 1- Id c3d 1,14- 4 / L A e4J4.
Phone: ` /6 '7`16 737
Date:
21412015