Form Mo 780 0925 PDF Details

The MO 780 0925 form plays a critical role for concentrated animal feeding operations (CAFOs) in Missouri, under the supervision of the Missouri Department of Natural Resources' Water Protection Program. This form is required for entities seeking approval or permits for either the construction or operation of CAFOs, as well as for those undergoing ownership transfers, renewals, or modifications of existing permits. Its comprehensive layout demands detailed information regarding the operation address, system location, and ownership details, alongside a requirement for a narrative description of the system and any changes since the previous permit was issued. Significantly, the form distinguishes between applications for construction, operations, and ownership transfer, defining specific sections of the form to be completed for each scenario. Engineering certification is necessary for projects completed under a construction permit or approval, ensuring that the constructed system aligns with approved plans and specifications, thereby affirming its compliance with environmental protection standards. Moreover, the document entails instructions on the application process, highlighting the submission of additional forms, permit fees, and supportive documents like operation and maintenance plans, geologic and soils reports, and nutrient management plans, which collectively aim at safeguarding water quality against the backdrop of CAFO operations.

QuestionAnswer
Form NameForm Mo 780 0925
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesMISSOURI, CERTIFCATION, CSR, subcontractors

Form Preview Example

MISSOURI DEPARTMENT OF NATURAL RESOURCES

WATER PROTECTION PROGRAM, WATER POLLUTION BRANCH

FORM F – APPLICATION FOR APPROVAL OR PERMIT FOR CONCENTRATED ANIMAL FEEDING OPERATION

FOR AGENCY USE ONLY

CHECK NO.

DATE RECEIVED

FEE SUBMITTED

 

 

TYPE APPLIED FOR: (CHECK ONE BOX IN EACH OF COLUMN A, B, AND C.) (SEE INSTRUCTIONS FOR APPROPRIATE FEE TO BE SUBMITTED WITH APPLICATION.)

A

B

C

 

 

 

 

 

CONSTRUCTION

LETTER OF APPROVAL

PERMIT RENEWAL

PERMIT NO.

OPERATING

GENERAL PERMIT

NEW OPERATION

MO –

OWNERSHIP TRANSFER

SITE-SPECIFIC PERMIT

SYSTEM MODIFICATION

EXPIRATION DATE

 

EXEMPTION REQUEST

OTHER

 

 

 

 

 

CONSTRUCTION APPLICATION: Complete part I of this form.

OPERATING APPLICATION: Complete parts I and II of this form. OWNERSHIP TRANSFER: Complete part I of this form.

PART 1 – APPLICANT INFORMATION

1.OPERATION

ADDRESS (PHYSICAL)

 

PHONE

 

 

 

FAX

 

 

CITY

STATE

 

ZIP CODE

 

 

 

 

 

2.

SYSTEM LOCATION

1/4

1/4 SEC.

TWP

RGE

COUNTY

 

 

 

 

 

 

 

 

 

3.

OWNER

 

 

 

 

PHONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FAX

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

CITY

 

 

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

4.

CONTINUING AUTHORITY NAME

 

 

 

 

PHONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FAX

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

CITY

 

 

STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

5. CURRENT APPROVAL OR PERMIT NUMBERS

LATITUDE

LONGITUDE

6. BRIEF DESCRIPTION OF SYSTEM

7. ANY CHANGES IN THE SYSTEM SINCE PREVIOUS PERMIT?

YES

NO (IF YES, DESCRIBE, ATTACH ADDITIONAL SHEETS IF NECESSARY)

8.ATTACH ALL PERTINENT INFORMATION (SEE INSTRUCTIONS):

9.I CERTIFY THAT I AM FAMILIAR WITH THE INFORMATION CONTAINED IN THE APPLICATION AND ATTACHMENTS, AND THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF, SUCH INFORMATION IS TRUE, COMPLETE AND ACCURATE.

PRINT NAME AND TITLE

APPLICANT’S SIGNATURE

DATE

PART II – ENGINEERING CERTIFICATION (AFFIX SEAL IN SPACE PROVIDED)

1.CONSTRUCTION UNDER CONSTRUCTION PERMIT OR APPROVAL NO. (WRITE “NONE” IF CONSTRUCTION APPROVAL WAS NOT OBTAINED )

2.IF THE ANSWER TO ITEM 1 IS “NONE”, COMPLETE ITEM 7 ON PART ONE.

3.IF THE SYSTEM CONSTRUCTED IS DIFFERENT FROM THE CONSTRUCTED IS DIFFERENT FROM THE CONSTRUCTION APPROVAL, ATTACH “AS-BUILT” PLANS, INDICATE CHANGED PORTIONS, AND EXPLAIN THE REASONS FOR THE CHANGES.

4.CERTIFICATION:

I, THE PROJECT ENGINEER ON THE ABOVE-DESCIRBED SYSTEMS, HEREBY CERTIFY THAT I HAVE INSPECTED THESE SYSTEMS AND FIND THEM TO BE CONSTRUCTED IN ACCORDANCE WITH THE APPROVED PLANS AND SPECIFICATIONS AND RECOMMEND THEIR ACCEPTANCE AND APPROVAL BY THE MISSOURI CLEAN WATER COMMISSION. THIS CERTIFCATION INCLUDES: LAGOONS OR STORAGE BASINS SEAL, WATER-LEVEL-MEASUREMENT GAUGES, PUMPING AND PIPING SYSTEMS, LAND-APPLICATION SYSTEM, OPERATING MANUAL, RECORD- KEEPING SYSTEM AND TRAINING, AND OTHER CONDITIONS CONTAINED IN THE CONSTRUCTION DOCUMENTS AND DEPARTMENT APPROVAL OR PERMIT.

PROJECT ENGINEER’S SIGNATURE

DATE

 

 

ENGINEER SEAL

MO 780-0925 (11-11)

PAGE 1 OR 1

INSTRUCTIONS FOR APPLICATION FROM F

FOR CONCENTRATED ANIMAL FEEDING OPERATION

Submit applications to the address shown on the application form to: Attention NPDES Permits and Engineering Section.

A.CONSTRUCTION PERMIT

Refer to 10 CSR 20-6.300, 10 CSR 20-8.020 and appropriate reference documents. Submit the following information:

1.Application Form F, Form I and/or Form R for site-specific permit.

2.Permit Fee: construction fee is $750. See below, C. Transfer of Ownership, for permit modification fees.

3.If Class I Facility and certain Class IB systems, submit application Form E and G for storm water land disturbance permit. Contact the department for additional information.

4.If applying for a site-specific operating permit, submit mailing list for all property owners for land application sites and all adjacent property owners.

5.Name and address of any local planning and zoning authority.

6.Narrative Summary of the Project Design.

7.Location Map: Topographic map showing building, lagoons, land application sites, property boundary and general features.

8.General layout drawings.

9.Operation and Maintenance Plan.

10.Geologic Report by the Geological Survey and Resource Assessment Division.

11.Soils Report.

12.Design Worksheets.

13.Construction Plan Drawings and specifications.

14.Nutrient Management Plan

15.Verification of compliance with Neighbor Notice.

16.Other relevant information, as needed.

B. OPERATING LETTER OF APPROVAL, GENERAL PERMIT OR SITE-SPECIFIC PERMIT

If you are applying to transfer from an operating Letter of Approval to a General Permit, complete items 1, 2 and 3. For other applications complete all applicable items, as follows:

1.Application Form F, Form I and/or Form R for site-specific permit.

2.Permit Fee: There is no fee for a letter of approval. General permit fee is $150.00 for life of the permit (up to 5 years). For a new (first time) site-specific permit, the permit fee ranges from $1,500 to $5,000, based on the number of animals; contact the department or refer to 10 CSR 20-6.011 for the appropriate permit fee. If you are applying for renewal of a site-specific permit, do not submit a permit fee; your permit fee will be billed to your on an annual basis. See below, C. Transfer of Ownership, for permit modification fees.

3.For new systems submit engineering certification for construction completed under a construction approval or construction permit. Submit as- built engineering plans, if construction approval/permit was not obtained.

4.Submit Items 6 through 15 listed under Section A of these instructions, if any of this information is NOT already on file with the construction application. This information must be updated as part of the permit renewal application.

5.If applying for a site-specific operating permit, submit a current mailing list for all property owners of land application sites and all adjacent property owners.

6.Name and address of any local planning and zoning authority.

7.Other relevant information, as needed.

C. TRANSFER OF OWNERSHIP

An operating letter of approval, construction permit or general operating permit may NOT be transferred. A site-specific operating permit may be transferred to a new owner if there have been no significant changes in the facility. To request a transfer, the new owner shall check the ownership transfer request block at the top of this application form and complete Part I. Signature of the transfer application will be the new owner’s certification that he has read and understands the operating requirements of the facility and that the wastewater loading and system operation is substantially unchanged. Permit modifications, including transfers, are subject to the following fees: 25% of annual fee. Business name and address changes where owner, operator and continuing authority remain and same are not considered transfers.

D.ENGINEERING CERTIFICATION

Part II, Item 4 of the application form contains a list of items that must be inspected and certified as completed in order to obtain a Letter of Approval for operation or an operating permit.

Exception: Partial certification or certification by subcontractors shall be attached to the application if consideration of these is requested due to special circumstances. Justification for exceptions must be provided and substantiated by as-built plans and operating manuals.

MO 780-0725 (11-11)

PAGE 2 OF 2

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