Confined Animal Feeding Operation Approval Renewal {51318}

Confined Animal Feeding Operation Approval Renewal State Form 51318 (4-03) (Required Form) This renewal form must be completed, signed, dated, and returned to IDEM prior to the expiration date of the current approval. This form may also be used to present a revised or updated Manure Management Plan if changes are made before the 5 year renewal period. The form should be sent to: Confined Feeding Program Indiana Department of Environmental Management 100 North Senate Avenue P.O. Box 6015 Indianapolis, Indiana 46206-6015 Farm ID No. (Log#), (or) Approval Number, AWDate of Last Approval: County of Operation: Owner Name (Name to which the Approval was issued): Name of Operation (if applicable): Mailing Address of Owner: Telephone Number (with area code): Email Address: Location of Operation (nearest crossroads or mailing address): If any of the above information is unknown, contact IDEM at 317/232-4473. Manure Management Plan Renewal Manure Testing: Sample Collection Procedures: Nutrient Assessment: Private Laboratory ­ nutrient analysis of sample N-Meter ­ nitrogen analysis of sample Other (explain)_______________________________________________________ ______ Sampling Frequency: Soil Testing: Collection Procedure: Management Unit (field level) Grid Method Other (explain) Nutrient Assessment: Private Laboratory ­ nutrient analysis of samples Other (explain) Sampling Frequency: American LegalNet, Inc. www.FormsWorkflow.com Operation & Land Application Maps or Manure Distribution Records: Attach USDA NRCS soil survey maps that identify the location of the operation and the boundary areas of all the spreading acreage currently available where manure can be applied. Please indicate the number of acres available for spreading on each outlined area (field). (OR) If a manure distribution program is used, attach manure distribution records. Applicable land use agreements or manure distribution records must be maintained by the CFO on site and available for review during an inspection. Modifications Please detail below any changes in manure storage capacity or animal species/type confined at the operation that have been made since the time of your last Approval. Please note that if you have constructed any confinement buildings or manure storage structures without prior approval from IDEM, you must submit an application for a new Confined Feeding Approval. By signing this form I attest that the information provided above is true and accurate. Submitted by: ___________ Date: ________ American LegalNet, Inc. www.FormsWorkflow.com