Download Form M Land Application

2540-PM-BWM0398
4/2006
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF WASTE MANAGEMENT
Date Prepared/Revised
DEP USE ONLY
Date Received
FORM M
LAND APPLICATION
This form must be fully and accurately completed. All required information must be typed or legibly printed in the spaces
provided. If additional space is necessary, identify each attached sheet as Form M, reference the item number and identify
the date prepared. The “date prepared/revised” on attached sheets should match the “date prepared/revised” on this page.
General References: Chapter 291
SECTION A. SITE IDENTIFIER
Applicant/permittee:
Site Name:
Facility ID (as issued by DEP):
SECTION B. GENERAL INFORMATION
1.
Identify the type of application proposal.
Agricultural Utilization
2.
Land Reclamation
Identify the type of waste and origin.
Residual waste
Other(s)
(Please specify)
origin:
a.
b.
c.
d.
Attach a completed Form U.
SECTION C. SOIL INFORMATION
1.
List each soil series present on site.
Source Providing Information:
a.
b.
c.
d.
e.
2.
Attach pit or excavation descriptions written in the following format:
Example:
Pit #
Pit #1
Pit #2
Depth
0" - 12”
Color
dark brown
Texture
sandy loam
Structure
granular
Consistence
friable
none
12" - 24”
yellowish brown
silt loam
subangular blocky
firm
none
24" - 40"
brown
loam
prismatic
hard
grayish brown mottles
40” +
bedrock
etc.
-1-
Mottling
2540-PM-BWM0398
4/2006
SECTION C. SOIL INFORMATION (continued)
3.
Has the site been used previously for waste application?
4.
Soil chemical analysis information. A minimum of one background chemical analysis from soil in each soil series at the
proposed facility is required. Attach copies of the original laboratory analysis reports and identify the methods of
sampling and analysis. Identify the sampling areas on the Form 4R or Form 2 map requirement – Phase 1. Complete
the following information:
Yes
No
Accreditation Number of laboratory performing the analysis
soil series
pH
The following on a dry weight basis.
phosphorus, ppm
cadmium, ppm
zinc, ppm
copper, ppm
nickel, ppm
lead, ppm
chromium, ppm
mercury, ppm
other
In addition, if waste was previously applied to the proposed permit area, include soil analyses from similar soils adjacent to
the facility where waste has not been applied.
soil series
pH
The following on a dry weight basis.
phosphorus, ppm
cadmium, ppm
zinc, ppm
copper, ppm
nickel, ppm
lead, ppm
chromium, ppm
mercury, ppm
other
5.
What is the maximum slope at the proposed site?
6.
What is the shallowest depth from the surface to the seasonal high water table?
A.
7.
How was the above determined?
What is the shallowest depth to the bedrock?
A.
8.
percent
inches
How was the above determined?
What is the flooding frequency of the site?
-2-
inches
2540-PM-BWM0398
A.
4/2006
How was the above determined?
SECTION D. SURFACE WATER INFORMATION
1.
Identify the name of the watershed which will receive water discharges from the proposed permit area and adjacent area.
2.
What are the uses of groundwater in the proposed permit area and adjacent area?
3.
Provide a description of any known groundwater quality problems in the proposed permit area and adjacent area.
SECTION E. SUPPLEMENTAL DATA
1.
2.
A written operational narrative for all land application sites shall be attached to discuss the following:
a.
The operating plan for the site including site preparation, the proposed life of the operation, and the total
weight or volume of waste that is proposed to be applied during the operation.
b.
The proposed application rate per acre and the dates when waste will be applied.
c.
A complete justification for the proposed loading rates, including an analysis of the effect of the proposed
loading rates over the lifetime of the facility on air, soil, water, and other natural resources.
d.
The method by which waste will be applied and incorporated into the soil, and the party responsible for
incorporation.
e.
The equipment to be used for site preparation, land application, waste incorporation, and seeding.
f.
The use of the proposed permit are after waste disposal has permanently ceased.
g.
The nuisance control plan to prevent health hazard or nuisances.
h.
The waste storage plan.
i.
The method by which the operator of waste application vehicle will determine the waste application rate during
the operation.
j.
The permit area markers to be used.
k.
The waste analysis schedule.
l.
An analysis of the effect the proposed operation and loading rates over the lifetime of the facility on the air,
water, vegetation, and other natural resources.
m.
For land reclamation attach copy of erosion and sedimentation control plan.
Additionally, the operational narrative for agricultural utilization sites shall include the following:
a.
The projected use of the crops.
b.
A nutrient management plan for the site, including:
1) A description of the kind and amount of fertilizers or soil conditioners that will be placed on the site in
addition to waste.
2) The number and kind of animals on the farm or property including the total nutrient value of manure
produced by those animals and the location where such manure is placed. Complete Section F, Manure
Management, on page 5 of this Form M.
3) An explanation and analysis of the effect on the soil of the additional nutrients that would be supplied by
the waste.
c.
Attach a copy of the farm conservation plan.
-3-
2540-PM-BWM0398
4/2006
SECTION F. MANURE MANAGEMENT
The nutrient management plan for the site is to include a manure management plan for the farm or property. The following calculations shall be completed to identify the
number and kind of animals on the farm or property, the total nutrient value of the manure produced by those animals and the location where such manure is placed.
Calculation 1: amount of manure nutrients available
1.
2.
Example for
dairy cattle
Your farm
Animal Type
Number of 1000-pound animal units:
a.
total wt: no. of animals x wt per animal
b.
animal units: total wt (Item 1a)  1000 lb.
50 x 1300 =
65,000
65 au
Animal days of manure added to storage:
a.
full days confined
b.
partial days confined:
200 days
hours continued  24 hours x no. of days
c.
12  24 x 165 =
83 days
equivalent days stored:
no. of full days (Item 2a) + number of partial days
(Item 2b)
3.
200 + 83 =
283 days
Tons of manure produced during storage period:
lb/day/animal unit (Table 4) x no. of animal units
(Item 1b) X equivalent days stored
(Item 2c)  2000 lb/ton
4.
(82 x 65 x 283)  2000 =
754 tons
Manure nutrients available:
TOTAL
tons of manure (Item 3) x total
(754 x l0 x.5) N
nutrients N, P2O5, K2O, (Table 4) or
3770 lbs.
(754 x 4) P2O5
3016 lbs
(754 x *) K2O
6032 lbs
manure analysis, x (for nitrogen only) nitrogen
availability (Table 5)
Calculation 2: Crop nutrient requirements for farm (exclude the proposed or permitted site acreage).
Crop
1.
Acres
Yield Per Acre
Nutrient
Crop Nutrient Requirements
(Table 2)
Requirement Per Acre (Table 2)
(Acres X Nutrient Requirement Per Acre)
N
P2O5
K2O
N
2.
3.
TOTAL
-4–
P2O5
K2O