<p> AEM Base Program – Year 6 2010-11 Page 1of 2 Tier 4 BMP System Implementation Documentation Form Submit one form for each farm, identifying the BMP system(s) and component practice(s) that payment for time spent on design, installation, and/or check out is being requested.</p><p>County: Filmore Date: 7-12-10 AEM Farm ID #: 12-019 Type of Farm: Dairy CAFO: Y N Planning Unit Priority: 1 11 Digit HUC: 123456789000</p><p> List the appropriate BMP systems from the NYS Agricultural Management Practices Catalogue that technical assistance was provided on and indicate if the assistance was for design, installation, and/or check out. BMP systems are listed in Table I of Section 7 of the AEM Base Program Year 6 Contract Policies & Participation Documents Manual.  NRCS Component Practices for each BMP system are listed on Table V of Section 7 of the AEM Base Program Year 6 Contract Policies & Participation Documents Manual.  Complete one table for each component NRCS conservation practice. Use Continuation Form if needed.  Please identify if a practice was cost-shared and what program or entity provided the funds.  By completing and submitting this form the District is signifying that all BMPs submitted for payment have been designed and/or installed to NRCS Standards & Specifications and that a person with appropriate Job Approval Authority, or a PE licensed in NY State, has signed off on the practice design and/or close out. The district is further signifying that appropriate documentation of such exists and is available for review. </p><p>Total Tier 4 BMP Technical Assistance for this farm BMP System Barnyard Runoff Management System Conservation Tillage</p><p>BMP System: Barnyard Runoff Management System Component Practice NRCS Unit # Tasks completed: (NRCS Practice) code Units Roof Runoff Structure 558 ft 200 Design x Install x Check out Approval authority provided by: Phred Fizer, NRCS AE </p><p>Was the practice installed? Yes No</p><p>Was the practice cost-shared? Yes No Program: EQIP</p><p>4/6/10 AEM Base Program – Year 5 2009-10 Page 2of 2 Tier 4 BMP System Implementation Documentation Form County: Filmore AEM ID #: 12-019</p><p>BMP System: Barnyard Runoff Management System Component Practice NRCS Unit # Tasks completed: (NRCS Practice) code Units Underground Outlet 620 ft 400 Design x 410 Install x Check out Approval authority provided by: Phred Fizer </p><p>Was the practice installed? Yes No</p><p>Was the practice cost-shared? Yes No Program: EQIP</p><p>BMP System: Barnyard Runoff Management System Component Practice NRCS Unit # Tasks completed: (NRCS Practice) code Units Heavy Use Area Protection 561 cy Design 3 Install x Check out Approval authority provided by: Phred Fizer </p><p>Was the practice installed? Yes No</p><p>Was the practice cost-shared? Yes No Program: EQIP</p><p>BMP System: Conservation Tillage Component Practice NRCS Unit # Tasks completed: (NRCS Practice) code Units Residue Mgmt. - Mulch till 345 ac Design Install 20 Check out x Approval authority provided by: Norm Petterson, NRCS Area Resource Cons. </p><p>Was the practice installed? Yes No</p><p>Was the practice cost-shared? Yes No Program: FL-LOWPA </p><p>- Add additional pages if needed -</p><p>Comments: </p><p>4/6/10</p>