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Site Survey Request

Kentucky No Discharge Operational Permit for Agricultural Wastes Handling System

For additional information, contact: KPDES Branch, (502) 564-3410.

Send completed form to the Division of Water Regional Office for the appropriate county.

To be completed by facilities that handle agricultural wastes.

Please print or type the following information. DATE OF SUBMITTAL:

AGENCY USE

I. GENERAL INFORMATION

A.  Applicant Name

B. Applicant Mailing Address (Street, Road, PO Box, etc.)

City, State, Zip Code

Telephone Number (include area code)

II. DESCRIPTION OF PROPOSED OPERATION

A. Type of animals Approximate number of each animal type on-site

B.  Planned method of waste storage

(holding pond, holding tank, stack pad, etc.)

C.  Approximate number of acres available for land application of wastes

III. PROJECT LOCATION

A.  Facility Location

B.  County where facility is located

Attach a US Geological Survey (USGS) quadrangle map which accurately locates the proposed facility and the land that will be used for manure disposal. Be sure to identify which USGS quadrangle map was used. USGS maps may be obtained from the Economic Development Cabinet, Map Sales Office, 133 Holmes Street, Frankfort, Kentucky 40601. Phone (502) 564-4715.

The Natural Resources and Environmental Protection Cabinet does not discriminate on the basis of race, color, national origin, sex, age, religion, or disability and provides, upon request, reasonable accommodations including auxiliary aids and services necessary to afford an individual with a disability an equal opportunity to participate in all services, programs, and activities. For an alternate form of this application, contact the KPDES Branch, Division of Water.

DEP 7032-Ag-Site 1 Revised October 2002

INSTRUCTIONS FOR

Site Survey Request

WHO MUST APPLY:

Anyone who plans to CONSTRUCT or INSTALL a LIQUID MANURE HANDLING SYSTEM, with or without assistance form the Natural Resources Conservation Service (NRCS), formerly Soil Conservation Service (SCS).

MINIMUM REQUIREMENTS:

Every system shall be designed to keep all manure and waste out of STREAMS and GROUNDWATER. Excess accumulated wastes shall be applied to suitable farmland.

·  Landowner contacts local NRCS office for assistance (optional).

·  Landowner submits waste management plan and Site Survey Request form to Division of Water Regional Office and concurrently submits waste management plan and short Form B to Division of Water Central Office.

·  If site is acceptable, Division of Water issues a construction permit to landowner and sends a copy to NRCS.

·  Landowner constructs/installs the waste handling facility and NRCS sends “as built” plans to the Division of Water Central Office (KPDES Branch).

·  Division of Water issues a Kentucky No Discharge Operational Permit (KNDOP) to landowner.

MORE INFORMATION:

·  Division of Water: KPDES Branch, (502) 564-3410

·  Natural Resources Conservation Service: Local representatives or central office (606) 224-7350.

DEP 7032-Ag-Site 1 Revised October 2002