"Updes Cafo General Permit Annual Report Form" - Utah

Updes Cafo General Permit Annual Report Form is a legal document that was released by the Utah Department of Environmental Quality - a government authority operating within Utah.

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UPDES CAFO GENERAL PERMIT
ANNUAL REPORT
Due April 1st of each year
(Attach additional sheets if needed)
1.
UPDES Permit Number: UTG
2.
Facility Name:
3.
Reporting period: January 1, 20_____ through December 31, 20_____.
4.
Report submitted by:
5.
Type of animals, number of animals, and type of confinement.
(Please report the maximum number of animals confined at any one time for the reporting period)
Confinement Type
Animal Type
Number of Animals
(Open Lot, Housed, etc.)
Beef
Veal Calves
Broilers
Layers
Turkeys
Swine under 55 lbs.
Swine over 55 lbs.
Cows (dry & milking)
Heifers
Sheep & Lambs
Horses
Other
6. Summary of the wastes generated and transferred during the year.
a. Estimated amount of manure generated during the year (tons and /or gallons):
b. Estimated amount of litter generated during the year (tons):
c. Estimated amount of compost generated during the year (tons):
d. Estimated amount of process wastewater generated during the year (gallons):
e. Estimated amount of manure transferred to other persons during the year (tons and/or gallons):
f. Estimated amountof litter transferred to other persons during the year (tons):
g. Estimated amount of compost transferred to other persons during the year (tons):
h. Estimated amount of wastewater transferred to other persons during the year (gallons):
7. Acres of land application during the year.
a. Total number of acres for land application covered by the NMP:
UPDES CAFO GENERAL PERMIT
ANNUAL REPORT
Due April 1st of each year
(Attach additional sheets if needed)
1.
UPDES Permit Number: UTG
2.
Facility Name:
3.
Reporting period: January 1, 20_____ through December 31, 20_____.
4.
Report submitted by:
5.
Type of animals, number of animals, and type of confinement.
(Please report the maximum number of animals confined at any one time for the reporting period)
Confinement Type
Animal Type
Number of Animals
(Open Lot, Housed, etc.)
Beef
Veal Calves
Broilers
Layers
Turkeys
Swine under 55 lbs.
Swine over 55 lbs.
Cows (dry & milking)
Heifers
Sheep & Lambs
Horses
Other
6. Summary of the wastes generated and transferred during the year.
a. Estimated amount of manure generated during the year (tons and /or gallons):
b. Estimated amount of litter generated during the year (tons):
c. Estimated amount of compost generated during the year (tons):
d. Estimated amount of process wastewater generated during the year (gallons):
e. Estimated amount of manure transferred to other persons during the year (tons and/or gallons):
f. Estimated amountof litter transferred to other persons during the year (tons):
g. Estimated amount of compost transferred to other persons during the year (tons):
h. Estimated amount of wastewater transferred to other persons during the year (gallons):
7. Acres of land application during the year.
a. Total number of acres for land application covered by the NMP:
b. Total number of acres under control of the CAFO that were used for land application of manure, letter, compost, and
process wastewater during the year:
8. Manure, litter, compost, and wastewater discharges and spills from the production area that occurred during the
year. (Include any permit-allowed discharges).
a. First Discharge
Date and time of discharge:
Estimated volume of discharge:
Where did the discharge go:
Description of how discharge occurred:
What was done to address the discharge:
b. Second Discharge
Date and time of discharge:
Estimated volume of discharge:
Where did the discharge go:
Description of how discharge occurred:
What was done to address the discharge:
c. Third Discharge
Date and time of discharge:
Estimated volume of discharge:
Where did the discharge go:
Description of how discharge occurred:
What was done to address the discharge:
9. Certified Planner Approval Statement
I certify that the current NMP implemented and utilized at my facility was approved by a NRCS approved certified
planner.
______________________________________________
__________________________
Operator Signature
Date
10. NMP information and land application summary. (attach additional pages if needed).
a. The actual crop(s) planted and actual yields for each field:
b. The actual nitrogen and phosphorus content of the manure, litter, compost, and process wastewater
c. The results of the calculations conducted in accordance with the Narrative Rate Approach in IX.E of the permit:
IX.E.1.a.
IX.E.1.b.
d. The amount of manure, litter, compost, and process wastewater applied to each field during the previous 12 months:
e. The following information is required for Narrative Rate approach NMPs:
i) The results of any soil testing for nitrogen and phosphorus taken during the previous 12 months:
ii) The data used in calculations to determine maximum amounts of manure, compost, litter, and process wastewater
to be land applied at least once each year according to IX.C.1.d:
iii) The amount of any supplemental fertilizer applied during the previous 12 months:
11. Permittee Certification Statement
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information including the possibility of fine
and imprisonment for knowing violations.
______________________________________________
__________________________
Operator Signature
Date
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