Form IL 406-1536 Livestock Waste Lagoon Registration Application - Illinois

Form IL406-1536 is a Illinois Department of Agriculture form also known as the "Livestock Waste Lagoon Registration Application". The latest edition of the form was released in January 1, 2001 and is available for digital filing.

Download an up-to-date Form IL406-1536 in PDF-format down below or look it up on the Illinois Department of Agriculture Forms website.

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L
W
L
IVESTOCK
ASTE
AGOON
R
A
EGISTRATION
PPLICATION
Please indicate the type of facility being registered: _____ New Lagoon;
_____ Modified Lagoon
Please indicate the address below that should be used for correspondence by placing a check on the line to the left of
the section.
___ A. Company/Owner Information.
Name:
Company:
Mailing Address:
Phone Number:
___ B. Manager/Operator Information.
(if different from company/owner information)
Name:
Company:
Mailing Address:
Phone Number:
___ C. Facility Information.
(if different from above)
Name:
Mailing Address:
Phone Number:
D. Lagoon Location Information.
1. General Location. Please provide the following information:
_________________________
__________
__________
____________
County Name
Township #
Range #
Prin. Meridian
_________
____________
____________
Section #
1/4 Section
1/4-1/4 Section
Page 1 of 6
IMPORTANT NOTICE: This state agency is requesting disclosure of information that is necessary to accomplish the statutory purpose as outlined under 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 406-1536 (1-01)
L
W
L
IVESTOCK
ASTE
AGOON
R
A
EGISTRATION
PPLICATION
Please indicate the type of facility being registered: _____ New Lagoon;
_____ Modified Lagoon
Please indicate the address below that should be used for correspondence by placing a check on the line to the left of
the section.
___ A. Company/Owner Information.
Name:
Company:
Mailing Address:
Phone Number:
___ B. Manager/Operator Information.
(if different from company/owner information)
Name:
Company:
Mailing Address:
Phone Number:
___ C. Facility Information.
(if different from above)
Name:
Mailing Address:
Phone Number:
D. Lagoon Location Information.
1. General Location. Please provide the following information:
_________________________
__________
__________
____________
County Name
Township #
Range #
Prin. Meridian
_________
____________
____________
Section #
1/4 Section
1/4-1/4 Section
Page 1 of 6
IMPORTANT NOTICE: This state agency is requesting disclosure of information that is necessary to accomplish the statutory purpose as outlined under 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 406-1536 (1-01)
2.
Facility Location Area Map. Provide a location map of the area surrounding the facility. Identify the
location of the lagoon relative to the following: a) roads; b) streams, rivers, and other water sources
such as surface and subsurface drains and waterways; c) on- and off-site private potable and non-
potable wells; d) public potable wells; e) residences; f) churches, businesses, and other common
places of assembly. Preferably this site map should be a copy of a U.S. Geological Survey
quadrangle map or the county plat book map with adequate scale to show required details.
On the location area map, indicate the distance from the outermost extent of the lagoon (exterior
berm toe) to the following:
Nearest private or public potable well(s)
________ ft.
Nearest on-site non-potable well(s)
________ ft.
Nearest abandoned or plugged well, drainage
well, or injection well
________ ft.
Nearest occupied residence(s) (other than any
occupied by the owner or operator)
________ ft.
Nearest stream(s)
________ ft.
Nearest “populated area(s)”
________ ft.
E. Type of Livestock and Animal Units.
Indicate the type and general size of livestock, the maximum number of animals, and the number of
animal units using the conversion factors as follows:
Swine < 55# = 0.03
Swine > 55# = 0.4
Cattle = 1.0
Dairy = 1.4
Young Dairy stock = 0.6
Sheep, Lambs or goats = 0.1
Horses = 2.0
Turkeys = 0.02
Laying hens or broilers = 0.005
Laying hens or broilers (if facility has overflow watering) = 0.01
Laying hens or broilers (if facility has liquid manure handling) = 0.03
Ducks = 0.02
Type
Number of
Conversion
Animal Units
Type
Number of
Conversion
Animal Units
Head (A)
Factor (B)
(A) X (B)
Head (A)
Factor (B)
(A) X (B)
Example: Sows
100
0.4
40
Facility Design Capacity in Animal Units --------
-
Registration of New or Modified Livestock Waste Lagoons
Page 2 of 6
F. Site Investigation Certification.
1.
Certification of site investigation by a Licensed Professional Engineer or Licensed Professional
Geologist:
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Engineer or Geologist Name [type or print]:
Registration #
Company Name
Address
City/State/zip code
Telephone
/
FAX
/
SIGNATURE:
Stamp or Seal
2.
Supporting justification and data. Please attach supporting
justification and data, pursuant to 8 Illinois Administrative Code 900.603(b)(8).
Registration of New or Modified Livestock Waste Lagoons
Page 3 of 6
G. Lagoon Design Plans and Specifications.
1.
Provide a lagoon plot plan indicating the location of livestock management structures or areas, on-
site wells, groundwater monitoring wells (if required), and subsurface drainage lines relative to the
location of the proposed lagoon. Indicate if any subsurface drainage lines have been relocated or
removed. Identify on the plan the 100 foot radius from the outer-most extent of the lagoon. Depict
surface water flow across and from the facility using contour lines or notation and arrows.
2.
On the above submitted plan drawing of the lagoon, include overall and component dimensions and
elevations referenced to a single facility benchmark.
3.
Provide cross-section drawings of the lagoon to indicate construction details, elevations, and
dimensions of the walls and floor, including the location and orientation of all transfer and/or
connecting piping.
4.
Provide the total surface area of the lagoon exposed to collect precipitation.
___________
5.
Provide the total animal weight used in the design based on the maximum
design capacity of the facility in animal units noted under Section E.
___________
6.
Provide the following volumes and, as a part of the registration, show the calculations in support of
the volumes (cubic feet):
(a)
Minimum design volume
__________ cubic feet
(b)
Livestock waste volume
__________ cubic feet
(c)
Washdown or dilution volume
__________ cubic feet
(d)
Runoff volume
__________ cubic feet
(e)
Sludge buildup volume or provide the
method to eliminate sludge buildup
__________ cubic feet
(f)
Indicate the proposed frequency of
sludge removal
__________ days
Total lagoon design volume [(a)+ (b) + (c) + (d) + (e)] . . . . . . . . . . . . .
__________ cubic feet
Registration of New or Modified Livestock Waste Lagoons
Page 4 of 6
H. Liner Plans and Specifications. (Complete this section only if a liner is being included in the
design of the lagoon.)
1.
Provide cross-section drawings, elevations, and dimensions including materials of construction,
liner thickness, and complete construction and installation details (including liner seam details, if
applicable).
2.
If a synthetic liner will be installed, provide liner maintenance guidelines; a manufacturer’s
statement of compatibility pertaining to the type of livestock waste to be stored and the supporting
soil material; and a listing of the liner specifications or physical properties.
I. Groundwater Monitoring. (Complete this section if monitoring wells are being included in the design
of the lagoon.)
1.
Provide plans for the groundwater monitoring program. Include the number; location; design;
depth; screened interval, screened depth and length; and other site-specific information for the
monitoring wells. Include information to demonstrate that a minimum of two (2) monitoring wells will
be located down gradient from the lagoon.
2.
Indicate the estimated depth to groundwater:
__________ feet below the land surface
3.
Indicate the seasonal low water table depth:
__________ feet below the land surface
4.
Include a narrative on well sampling procedures identifying techniques for collection, preservation,
shipment, and chain of custody control.
5.
Include a narrative indicating the method(s) of analysis and statement indicating that the samples
will be analyzed for the analytes listed at 8 Illinois Administrative Code 900.611 (c).
J. Construction Dates.
List the anticipated beginning and ending dates of construction.
Beginning date: _______/_______/_______
Ending date: _______/_______/_______
Registration of New or Modified Livestock Waste Lagoons
Page 5 of 6

Download Form IL 406-1536 Livestock Waste Lagoon Registration Application - Illinois

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