Indiana > Statewide > Department Of Enviromental Management > Land
Confined Animal Feeding Operation Request For Approval Voidance 49827 - Indiana
| Confined Animal Feeding Operation Request For Approval Voidance Form. This is a Indiana form and can be used in Land Department Of Enviromental Management Statewide . |
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CONFINED FEEDING OPERATION REQUEST FOR APPROVAL VOIDANCE State Form 49827(R2 / 11-12) INSTRUCTIONS: Complete, sign, date, and return this form to the address above. INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Confined Feeding Section Office of Land Quality 100 North Senate Avenue MC 65-45, IGCN 1101 Indianapolis, Indiana 46204 I. GENERAL INFORMATION Farm ID Number (Log Number): Date of Last Approval: (month, day, year) (or) Approval Number: County of Operation: AW- Owner Name (Name to which the Approval was issued): Name of Operation (if applicable): Mailing Address of Owner: Telephone Number (with area code): Location of Operation (nearest crossroads or mailing address): If any of the above information is unknown, contact IDEM at 317/232-4473. Email Address: II. VOIDANCE INFORMATION I am requesting my approval be voided because (check all that apply): My operation currently does not meet the definition of a confined feeding operation under the statute IC 13-11-2-40(1) and (3) which states: "Confined feeding operation", for purposes of IC 13-18-10, means: (1) any confined feeding of: (A) at least three hundred (300) cattle; (B) at least six hundred (600) swine or sheep; (C) at least thirty thousand (30,000) fowl; and (D) at least five hundred (500) horses; or (3) any animal feeding operation that is causing a violation of: (A) water pollution control laws; (B) any rules of the water pollution control board; or (C) IC 13-18-10. I no longer confine livestock at the above-referenced facility. I have removed all manure stored in pits and/or lagoons at the above-referenced facility. By submitting this request for voidance I understand that my request will be reviewed by IDEM staff and an Agricultural Waste Inspector will visit my farm to confirm that manure has been properly removed from any lagoons, pits, or tanks. If a voidance is granted, I understand that I will be removed from the list of approved operations and will not have to meet the requirements of my approval or submit a manure management plan to IDEM once every five (5) years. If I intend at some point in the future to increase the size of my operation above the animal numbers required in IC 13-18-10 I must seek a new approval prior to increasing the size of the operation. III. SIGNATURE I affirm that the information on this form is, to the best of my knowledge and belief, true, complete and accurate. I am aware of the penalties for knowingly submitting false information under IC 35-44-2-1. Signature Date (month, day, year) American LegalNet, Inc. www.FormsWorkFlow.com
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