Section 1. About Your Farm

Questionnaire to provide Price Proposal

For services to prepare Nutrient Management Plans & Provide CAFO NPDES Permit Assistance

Purpose:

1. Obtain basic farm information required to quote prices for environmental services that producer may be interested in obtaining from ManPlan Inc.

2. Develop insight into current level of nutrient planning implementation for manure storage, land application, land treatment, manure export, and feed management.

3. Determine producer’s needs to meet regulatory requirements and timeline to meet deadlines.

Please return questionaires electronically to: [email protected]

ManPlan Contact Information: Questions or additional information can be obtained from: Dennis Godar, Operations Director, (217) 622-4199, [email protected] Joe Lally, Environmental Associate, (712) 263-9729, [email protected] Cindy Logsdon, GIS Technician (217) 498-8817, [email protected] Molly Ann Godar, Business Manager, (217) 498-8817, [email protected]

Home Office address: 8810 Buckhart Road Rochester, Illinois 62563

ManPlan Inc Office: 217 498-8817 Fax 800 633-2814 (Fill in between the < > symbols.), This document can be emailed back to [email protected]

Name of operation: 1. Owner: < > 2. Owner’s address: < > 3. Telephone: < > CELL: < >

4. Person to contact regarding this price proposal: Name: < > Title: < > Telephone: < > CELL: < > Address: < > < >

5. Location of operation: State: < > (County) < > (Township) < > (Section) < > (Quarter) < >

6. Operation’s address: < > < >

7. Estimated total area of open feedlot Acres < > or dimensions: < >

8. Number and capacity of manure and wastewater storage and handling systems: Settling Tanks: < > Settling Basins: < > Manure Pits: < > Outside Liquid Storage: < > Stacking Pads: Covered: < > Un-Covered: < > Lagoons: < > Storage Ponds: < > Center Pivots: < > Traveling Guns: < >

9. Acres Available for Solid Manure Applications: < >

10. Acres Available for Liquid Manure Applications: < >

11. Manure Transferred off-site Annually, Gallons: < > Tons: < >

ManPlan Inc Office: 217 498-8817 Fax 800 633-2814 Questions concerning Open Feedlots, with Outside Lots

12. Does the operation currently have an NPDES permit? < >

13. Has the operation applied for an NPDES permit? < >

14. Has the operation registered with DNR as an Open Feedlot? < >

15. Does the operation have proper soil tests on fields that will receive manure? applications? (eg: at least 1 composite sample per 10 acres for Iowa DNR) < >

16. Does the operation have recent manure test results from liquid and solid? manure storages? < >

Questions concerning Confinement Feeding Operations: (Roofed facilities such as swine, poultry or deep bedded barns; NO outside lots)

17. Does the operation need a Manure Management Plan update using the new Iowa Phosphorus Index? < >

EQIP / CNMP’s:

18. Is the operation interested in working with NRCS to apply for EQIP (Environmental Quality Incentive Program) cost sharing programs? < >

19. Does the operation need a CNMP? A Comprehensive Nutrient Management Plan (CNMP) is required if the operation has an EQIP contract. < >

20. What are your greatest environmental or regulatory concerns? < >

ManPlan Inc Office: 217 498-8817 Fax 800 633-2814 1. Land resources controled by this opertion: (Fill-in table )

Irrigated Land Under Your Dryland Under Your Management Management Average Yield Acres Average Yield Acres Acres Acres Crop: per Acre Manured per Acre Manured

Corn for grain bu. bu. Corn for silage ton ton Soybeans bu. bu. Wheat bu. bu. Mostly Legume Hay ton ton Mostly Grass Hay ton ton Other: Other: Other:

2. Animals (average full capacity and numbers finished per year). Facilities One- Number of Approximat Approximate Feedlot Cattle Time Capacity Animals Finished e Storage (# of animals) per year Area of Lots Capacity Under 500 lbs 500 – 1000 lbs Over 1000 lbs

Number of Facilities One- Animals Approximate Approximate Dairy Cattle Time Capacity Finished per Area of Lots Storage Capacity (# of animals) year Calves < 500 lbs Heifers Dry Cows Lactating Cows

ManPlan Inc Office: 217 498-8817 Fax 800 633-2814