Non-lagoon Livestock Waste Handling Facility Initial Perimeter Drain Sample - Illinois

This printable "Non-lagoon Livestock Waste Handling Facility Initial Perimeter Drain Sample" is a document issued by the Illinois Department of Agriculture specifically for Illinois residents.

Download a PDF of the latest edition of the form down below or find it through the department's forms library.

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N
-L
L
W
H
F
ON
AGOON
IVESTOCK
ASTE
ANDLING
ACILITY
I
P
D
S
NITIAL
ERIMETER
RAIN
AMPLE
A. Facility Information:
Name:
____________________________________________________________________
_
Mailing Address:
____________________________________________________________________
____________________________________________________________________
Phone Number:
____________________________________________________________________
Facility ID #:
LF___ ___ ___ ___ ___ ___ ___ ___ ___ ___
B. Owner or Operator Information:
Name:
____________________________________________________________________
Company:
____________________________________________________________________
Mailing Address:
____________________________________________________________________
Phone Number:
_____________________________
C. Perimeter Drainage Tubing Requirements:
Pursuant to 35 Ill. Adm. Code 900.511, facilities required to install a perimeter drainage tubing are
required to sample liquid from the monitoring port prior to the livestock waste handling facility being
placed into service and at least quarterly thereafter, if any liquid is available. The samples must be
analyzed for the following items: nitrate-nitrogen, phosphate-phosphorus, chloride, sulfate and
ammonia-nitrogen.
Results of the analysis must be submitted to the Department within 30 days after sample collection.
Date of Initial Sample Collection(s): ___/___/___
___/___/___
Signature of the Owner or Operator
(Date)
Submit to:
Illinois Department of Agriculture
Livestock Management Facilities Program
P.O. Box 19281
Springfield, IL 62794-9281
N
-L
L
W
H
F
ON
AGOON
IVESTOCK
ASTE
ANDLING
ACILITY
I
P
D
S
NITIAL
ERIMETER
RAIN
AMPLE
A. Facility Information:
Name:
____________________________________________________________________
_
Mailing Address:
____________________________________________________________________
____________________________________________________________________
Phone Number:
____________________________________________________________________
Facility ID #:
LF___ ___ ___ ___ ___ ___ ___ ___ ___ ___
B. Owner or Operator Information:
Name:
____________________________________________________________________
Company:
____________________________________________________________________
Mailing Address:
____________________________________________________________________
Phone Number:
_____________________________
C. Perimeter Drainage Tubing Requirements:
Pursuant to 35 Ill. Adm. Code 900.511, facilities required to install a perimeter drainage tubing are
required to sample liquid from the monitoring port prior to the livestock waste handling facility being
placed into service and at least quarterly thereafter, if any liquid is available. The samples must be
analyzed for the following items: nitrate-nitrogen, phosphate-phosphorus, chloride, sulfate and
ammonia-nitrogen.
Results of the analysis must be submitted to the Department within 30 days after sample collection.
Date of Initial Sample Collection(s): ___/___/___
___/___/___
Signature of the Owner or Operator
(Date)
Submit to:
Illinois Department of Agriculture
Livestock Management Facilities Program
P.O. Box 19281
Springfield, IL 62794-9281
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