Attachment C - EGLE Agricultural Use Agreement Site Identification Form.pdf
PDF 64 KB Posted
- Solicitation number
- RFP - 751 - 230000002643
- Issued by
- Benzie County, Bergland CDP, Michigan
About this file
This document is an Agricultural Use Approval Site Identification Form from the Michigan Department of Environment, Great Lakes, and Energy (EGLE) Materials Management Division. It provides details on the requirements for obtaining approval to land apply agricultural waste on a specific site. The form requires information on the site location, ownership, soil characteristics, and intended crops and application methods. Attachments such as a Farm Services Agency map, soil test analysis, plat map, and soil survey map must be provided to complete the application. The form is applicable to sites in Benzie County and Bergland CDP, Michigan under the state's Part 115 Solid Waste Management rules.
The pricing and funding details are not specified in this document, as it is focused on the site identification and approval process rather than a contract opportunity. The document does not mention any incumbents, set-asides, or other salient pricing or contracting information.
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Text version
MICHIGAN DEPARTMENT OF ENVIRONMENT, GREAT LAKES, AND ENERGY
MATERIALS MANAGEMENT DIVISION
AGRICULTURAL USE APPROVAL
SITE IDENTIFICATION FORM
Applicable Rule: Part 115, Solid Waste Management, of the Natural Resources and Environmental Protection Act, 1994 PA 451, as amended, and the rules promulgated pursuant to Part 115; specifically, R 299.4111 of the Part 115 administrative rules.
Complete the following information and provide the attachments listed below for each new site or existing site that has not had a Site Identification Form with attachments submitted to the EGLE since January 1, 2019. Please amend any previous Site Identification Forms when it becomes known that any of the information requested below has changed (i.e., new landowner).
Environmental Assistance Center Michigan.gov/EGLE Phone: 800-662-9278 Page 1 of 1 EQP5230 (10/19
FACILITY NAME AGRICULTURAL USE APPROVAL NUMBER
SITE IDENTIFICATION FORM
A. Site ID (Assigned by generator)
Waste Data System ID# Street or Route #
B. County/Township:
County Township
C. State Planar Coordinates: 1/4 1/4
Section Town Range
D. Lat/Long (5 numbers past decimal point):
Latitude Longitude Method Used (i.e., GPS, topo)
E. Site Ownership
Name of Owner Phone
Street or P.O. Box
City or Town State Zip
A written agreement from the owner to land apply is required. Do you have one?
Yes
No. One will be obtained.
Describe how to find the site.
Will the site be used for winter application?
Yes No
Name of Lessee (if different) Phone
Street or P.O. Box
City or Town State Zip
F. Site Characteristics Site Type
Agricultural
Forest
Reclamation Site
Lawn/Home Garden
Soils Information
Date of last soils analysis
*Phosphorous units
Potassium units pH Soil type(s)
*300 lb/ac Bray P1 maximum
Expected crops/vegetation to be grown
Crop/Vegetation Nitrogen Requirement lbs. N/acre lbs. N/acre lbs. N/acre Percent slope
Highest percent slope of the site?
0-6%
6-12%
*Higher (Requires an approved site reclamation plan)
Total acreage of site
Acreage allowed for land application
(Total acreage minus any setback for property lines, homes, water bodies, etc.)
Application Rate gal/acre ton/acre
Application Method
Surface Spreading Subsurface Injection
If agricultural, is the site tiled?
Yes No NA
On an attached sheet provide a copy of the following:
• A Farm Services Agency map (formerly ASCS) of the proposed application site with property boundaries, setback distance for application, surface waters, and discharge location of field tiles when present.
• A copy of the soil test analysis that is no older than 2 years old at the time of land application.
• A copy of the plat map (or other map showing property dimensions) with the proposed land application site highlighted.
• A soil survey map with the land application site identified.
File details come from the government source that posted it. Updated .