Form IL 406-1537 Waste Management Plan Certification Form - Illinois

Form IL406-1537 or the "Waste Management Plan Certification Form" is a form issued by the Illinois Department of Agriculture.

The form was last revised in January 1, 2001 and is available for digital filing. Download an up-to-date Form IL406-1537 in PDF-format down below or look it up on the Illinois Department of Agriculture Forms website.

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W
M
P
ASTE
ANAGEMENT
LAN
C
F
ERTIFICATION
ORM
I, the undersigned, do hereby certify that a Waste Management Plan for the livestock management facility
named below has been prepared in accordance with the requirements of the Livestock Management Facilities
Act [510 ILCS 77/1 et seq.] and the rules promulgated thereunder.
Livestock Management Facility Information:
Facility Name: ______________________________________________________________
Company:
______________________________________________________________
Address:
______________________________________________________________
______________________________________________________________
Phone:
_______/_________________
Total # of Animal Units:_______________
Species:_______________
Owner/Operator Information:
Facility Name: ______________________________________________________________
Company:
______________________________________________________________
Address:
______________________________________________________________
______________________________________________________________
Phone:
_______/_________________
Waste Management Plan Location:
____________________________________________________________________________
____________________________________________________________________________
_________________________________________________________________________
_______________________________________
_____________________
Signature of Owner or Operator
Date
IMPORTANT NOTICE: This state agency is requesting disclosure of information that is necessary to accomplish the statutory purpose as outlined under the Environmental Protection Act
(415 ILCS 5) and the Livestock Management Facilities Act (510 ILCS 77/1 et seq.). Failure to provide this information shall prevent this form from being processed. This form has been
approved by the State Forms Management Center.
IL 406-1537 (01-01)
W
M
P
ASTE
ANAGEMENT
LAN
C
F
ERTIFICATION
ORM
I, the undersigned, do hereby certify that a Waste Management Plan for the livestock management facility
named below has been prepared in accordance with the requirements of the Livestock Management Facilities
Act [510 ILCS 77/1 et seq.] and the rules promulgated thereunder.
Livestock Management Facility Information:
Facility Name: ______________________________________________________________
Company:
______________________________________________________________
Address:
______________________________________________________________
______________________________________________________________
Phone:
_______/_________________
Total # of Animal Units:_______________
Species:_______________
Owner/Operator Information:
Facility Name: ______________________________________________________________
Company:
______________________________________________________________
Address:
______________________________________________________________
______________________________________________________________
Phone:
_______/_________________
Waste Management Plan Location:
____________________________________________________________________________
____________________________________________________________________________
_________________________________________________________________________
_______________________________________
_____________________
Signature of Owner or Operator
Date
IMPORTANT NOTICE: This state agency is requesting disclosure of information that is necessary to accomplish the statutory purpose as outlined under the Environmental Protection Act
(415 ILCS 5) and the Livestock Management Facilities Act (510 ILCS 77/1 et seq.). Failure to provide this information shall prevent this form from being processed. This form has been
approved by the State Forms Management Center.
IL 406-1537 (01-01)

Download Form IL 406-1537 Waste Management Plan Certification Form - Illinois

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