manure management self-reporting survey

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1. First Name

2. Last name

3. Address (please use the address covered in the manure plan)

4. Address 2

5. City

6. State

7. Zip Code

8. County

9. Phone number

10. If the address covered by the manure plan is different from your mailing address,please provide your mailing address below.

11. Number of cropland acres covered in manure management plan

12. Number of acres in pasture covered in manure management plan

13. Number of acres in hay covered in manure management plan

Manure Management Self-ReportingManure Management Self-ReportingManure Management Self-ReportingManure Management Self-Reporting*14. Manure animal typePlease choose one dominant animal type producing the manure used on your operation.

Dairy Animals

Beef

Pigs

Poultry

Turkey

Sheep

Horse

Other

Other (please specify)

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*15. What is the date the manure management plan was implemented?Month

Year

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Assistance preparing plan

16. Who or where did you get information to assist you in preparing the plan? (Select allthat apply)

Conservation district one­on­one assistance

Conservation district workshop

Private sector/nutrient management planners

Certified crop advisor

None

Other (please specify)

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*17. Do you have one or more animal waste management systems (manure storages) forDairy?

Yes

No

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*18. Do you have one or more animal waste management systems (manure storages) forBeef?

Yes

No

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*19. Were any county, state, or federal government funds used to construct this manurestorage for Dairy?

Yes

No

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*20. Were any county, state, or federal government funds used to construct this manurestorage for Beef?

Yes

No

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*21. Do you have one or more animal waste management systems (manure storages) forPoultry?

Yes

No

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*22. Were any county, state, or federal government funds used to construct this manurestorage for Poultry?

Yes

No

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*23. Do you have one or more animal waste management systems (manure storages) forSwine?

Yes

No

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*24. Were any county, state, or federal government funds used to construct this manurestorage for Swine?

Yes

No

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*25. Do you have stream bank fencing?Yes

No

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*26. Were any county, state, or federal government funds used to construct this streambank fencing?

Yes

No

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*27. Do you have barnyard runoff controls?(This includes practices such as roof runoff control, diversion of clean water from enteringthe barnyard and control of runoff from barnyard areas.)

Yes

No

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*28. Which practice(s)Enter the year built for all that apply:Roof Gutters

Roof Runoff Structures

Concrete Barnyards

Curbs

Collection System and/orPumps

Barnyard Runoff Filter Strip

Exclusion Fencing

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*29. Were any government funds used to construct these barnyard runoff controls?Yes

No

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Dairy Manure Storage Not Paid For with Government Funds

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30. Year(s) dairy manure storage builtYear

Year

Year

Year

31. Number of animals

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Beef Manure Storage Not Paid for with Government Funds

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32. Year(s) beef manure storage builtYear

Year

Year

Year

33. Number of animals

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Poultry Manure Storage Not Paid for with Government Funds

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34. Year(s) poultry manure storage builtYear

Year

Year

Year

35. Number of animals (yearly production)

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Swine Manure Storage Not Paid for with Government Funds

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36. Year(s) swine manure storage builtYear

Year

Year

Year

37. Number of animals (yearly production)

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Stream Bank Fencing Not Paid for with Government Funds

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38. Year(s) stream bank fencing builtYear

Year

39. Average width from stream bank to fencing (in feet). This is the width of your buffer.

40. Length of fence (in feet)

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Barnyard Runoff Controls Not Paid for with Government Funds

*41. Year(s) barnyard runoff control builtYear

Year

Year

Year