Form MO 780-1953 Concentrated Animal Feeding Operation Annual Report - Water Protection Program - Missouri

Form MO780-1953 or the "Concentrated Animal Feeding Operation Annual Report - Water Protection Program" is a form issued by the Missouri Department of Natural Resources.

The form was last revised in August 1, 2012 and is available for digital filing. Download an up-to-date Form MO780-1953 in PDF-format down below or look it up on the Missouri Department of Natural Resources Forms website.

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MISSOURI DEPARTMENT OF NATURAL RESOURCES
WATER PROTECTION PROGRAM, WATER POLLUTION CONTROL BRANCH
CONCENTRATED ANIMAL FEEDING OPERATION
ANNUAL REPORT
Submit the completed report by February 15 of each year to:
Missouri Department of Natural Resources, Water Protection Program,
P.O. Box 176, Jefferson City, MO 65102.
For additional information or questions call (573) 751-1300.
PART 1 - PERMIT INFORMATION
1.1 Operation Name
Permit Number
Reporting Period
(Month/Year)
MO-G
to
Address
County
Phone
City
State
Zip Code
Email address
1.2 Owner (Person or Legal Entity)
Phone
City
State
Zip Code
Address
(Check if this is a change of address.)
PART 2 – OPERATION SUMMARY INFORMATION
2.1 Is this an export only operation?
Yes
No
2.2 Number and Type of Animals in Confinement Under Roof
2.3 Number and Type of Animals in Open (un-roofed) Confinement
2.4 Total Process Waste Generated in Reporting Period (gal /or tons)
2.5 Total Process Waste Transferred to Other Parties in Reporting Period
2.6 Number of Land Application Acres Included in Nutrient Management
2.7 Number of NMP Acres Used for Land Application in Reporting Period
Plan (NMP)
2.8 Were There Any Revisions to the NMP? (MOG01 permits only)
2.9 Date soil tests were taken that was used in development
Yes
No
(If yes, attach revisions if not previously submitted)
of the NMP. (MOGS1 permits only)
(Month/Year)
PART 3 – SPILLS AND OVERFLOWS
Were there any emergency or unauthorized discharges during the reporting period?
No-Discharge
Yes (If yes, attach Sheet 1A. from CAFO Record Keeping Forms)
PART 4 – SIGNATURE
I certify that I am familiar with the information contained in the report and attachments, and to the best of my knowledge and belief, such information is
true complete and accurate.
Name
Title
Signature
Date
Additional Comments:
MO 780-1953 (8/12)
MISSOURI DEPARTMENT OF NATURAL RESOURCES
WATER PROTECTION PROGRAM, WATER POLLUTION CONTROL BRANCH
CONCENTRATED ANIMAL FEEDING OPERATION
ANNUAL REPORT
Submit the completed report by February 15 of each year to:
Missouri Department of Natural Resources, Water Protection Program,
P.O. Box 176, Jefferson City, MO 65102.
For additional information or questions call (573) 751-1300.
PART 1 - PERMIT INFORMATION
1.1 Operation Name
Permit Number
Reporting Period
(Month/Year)
MO-G
to
Address
County
Phone
City
State
Zip Code
Email address
1.2 Owner (Person or Legal Entity)
Phone
City
State
Zip Code
Address
(Check if this is a change of address.)
PART 2 – OPERATION SUMMARY INFORMATION
2.1 Is this an export only operation?
Yes
No
2.2 Number and Type of Animals in Confinement Under Roof
2.3 Number and Type of Animals in Open (un-roofed) Confinement
2.4 Total Process Waste Generated in Reporting Period (gal /or tons)
2.5 Total Process Waste Transferred to Other Parties in Reporting Period
2.6 Number of Land Application Acres Included in Nutrient Management
2.7 Number of NMP Acres Used for Land Application in Reporting Period
Plan (NMP)
2.8 Were There Any Revisions to the NMP? (MOG01 permits only)
2.9 Date soil tests were taken that was used in development
Yes
No
(If yes, attach revisions if not previously submitted)
of the NMP. (MOGS1 permits only)
(Month/Year)
PART 3 – SPILLS AND OVERFLOWS
Were there any emergency or unauthorized discharges during the reporting period?
No-Discharge
Yes (If yes, attach Sheet 1A. from CAFO Record Keeping Forms)
PART 4 – SIGNATURE
I certify that I am familiar with the information contained in the report and attachments, and to the best of my knowledge and belief, such information is
true complete and accurate.
Name
Title
Signature
Date
Additional Comments:
MO 780-1953 (8/12)
Parts 5 through 7 to be completed for MOG01 permits only.
PART 5 – ANNUAL MANURE TESTING RESULTS
Attach lab analysis results or Sheet 2A from CAFO Record Keeping Forms for each source of manure. (This is required for all operations
including export only operations.)
PART 6 – SOIL TESTING RESULTS
Were soil tests conducted during the reporting period?
Yes
No
If yes, attach lab analysis results or Sheet 2B from
CAFO Record Keeping Forms
PART 7 – LAND APPLICATION ANNUAL SUMMARY BY FIELD (ATTACH ADDITIONAL SHEETS IF NECESSARY)
Operation Name
Permit Number
MO-G
County
Year
Land Application Equipment
Other Fertilizer
Applied During Reporting Period
Manure
Type of
Applied
Planned Yield
Actual Yield
gal. or tons
gal. or tons/acre
Field ID
Acres
Source
Manure
Crop
lbs N/acre
Bu. or ton/ acre
Bu. or ton/acre
MO 780-1953 (8/12)
CAFO Annual Report Instructions
GENERAL: MOGS1 (State No-Discharge) permitees complete Parts 1-4 (except 2.8). MOG01 (NPDES) permitees complete
Parts 1-7 (except 2.9). The annual report is due by February 15 for the previous calendar year. Complete a separate form for each
permit number. Send only the record keeping forms that are required for the Annual Report. Liquid manure storage level readings,
precipitation records, and manure transfer records do not need to be submitted.
PART 1 - PERMIT INFORMATON. This is general information for the operation and can be copied from your current permit, if it is the
same. For ownership transfers or modifications submit a Form W and permit modification fee.
PART 2 – OPERATION SUMMARY INFORMATION. 2.1 – An export only operation is one that sells or transfers all generated process
wastes to other parties. If any process waste is land applied on fields that are owned, rented, leased or controlled by the CAFO
owner/operator, it is not an export only operation.
2.2– From the table below, enter the code for each animal category and the maximum number of animals housed under roof at any one
time during the reporting period.
Code
Code
Animal Category
Animal Category
Beef/feeder cattle, veal calves, cow/calf
1
7
Chicken laying hens and broilers with wet handling system
pairs,dairy heifers
2
Horses
8
Chicken laying hens without wet handling system
3
Mature Dairy cows
9
Turkeys in growout phase
4
Swine under 55 lbs.
Chicken broilers, pullets and turkey poults in brood phase all
10
without wet handling system
5
Swine over 55 lbs.
Other (specify) Contact the Water Protection Program for
6
Sheep, lambs, meat & dairy goats
11
Animal Equivalent Units and SIC Codes for other animal types.
2.3 – Same as 2.1 except for animals in open confinement. Do not include animals in pasture.
2.4 – Record the amount (gallons for liquids, tons for solids) of process waste generated during the reporting period. Process waste
includes manure, litter, compost (including bedding), slurry, process wastewater, mortality compost, sludge, contaminated rainwater,
etc.
The amount can be estimated.
2.5 – Record the amount (gallons for liquids, tons for solids) of process waste exported during the reporting period. This information is
the total from Sheet 1C from the CAFO Record Keeping Forms.
2.6 – Enter the number of spreadable acres that are included in a Nutrient Management Plan (NMP).
2.7 – Enter the number of acres used for land application during the reporting period that are included in a NMP. Include only the fields
that are owned, rented, leased and controlled by the CAFO owner/operator.
2.8 – MOG01 permits only. If any revisions were made to your NMP during the reporting period, those revisions must be submitted
with the annual report if they have not already been submitted. The entire updated plan may be submitted on a compact disc with a
letter identifying what revisions were made.
2.9 – MOGS1 permits only. Enter the date soil tests were taken that was used in development of the NMP. This is not required for
export only operations. The NMP does not need to be submitted.
PART 3 – SPILLS AND OVERFLOWS. If no discharge occurred, report as No-Discharge. If yes, complete and submit Sheet 1A of
CAFO Record Keeping Forms.
PART 4 - SIGNATURE. Sign and date the report.
PARTS 5 THROUGH 7 TO BE COMPLETED FOR MOG01 PERMITS ONLY
PART 5 - MANURE TESTSING RUSULTS. Include the annual manure analysis for each manure source. Testing manure for nutrient
content is required for all CAFO’s including those that are export only. Manure sources include, but are not limited to, multiple lagoons,
deep pit, litter, mortality compost, and sludge. (Multi-cell lagoons are considered one lagoon.).
PART 6 - SOIL TESTING RESULTS. Include soil testing results that were taken during the reporting period. Soil sampling for each
field in the NMP is required at minimum once every five years. This is not required for export only operations.
PART 7 - LAND APPLICATION SUMMARY BY FIELD. For fields included in a NMP, provide a summary of land application for each
field that received process waste during the past twelve (12) months. Attach additional sheets as necessary. This is not required for
export only operations.

Download Form MO 780-1953 Concentrated Animal Feeding Operation Annual Report - Water Protection Program - Missouri

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