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( (p*  0 " %" " @@ @  @ a@@ a@ a @  +&@@ +&@ +& @ "@@   @ "@  @@  @ @@  @ `@ ` `` @@ ( @ @ ( @ (  @  @*  ` @  ` @ @ ` @  @   @  *     *    ` * ` ` @@ @ a@@ a@ @  @ @ @ @ @ @ @  @  @@ @ ` @    @@  @  ` @  @@ @  @ @   @    0@ @  ` 8  @@ @ ` @ (@@ (@ (` @ "@   '@ 0 0` @  @   *   * @@ @  @ @  `  @ +0@   0  ( @   &@* &@ @@ 0@ 0@ 0` @ 0@ "@@ "@ "` @  !@@  !@  "a@  0a@  0`a @   @@  @  ` @  `@  `  ``  (`@ * (` * (`` *  `@  `  `` "@ " "`  @@ (@ (` @ @@ @  @ @@  @   @  @     @        @@ @  @ @   1!< )8 * *  8 !8 !8 )8 8 8 + #8 8  " " "@@ "@ "` @  @@)  @)  ` @  @)  )  ` !`@ ) !` )  ``  # "@@ " "@@ "` "@ "` @ @@ @ ` @ "@@ " @  @*  @   @  *     ` *  `  `  1@@ *  1@ *  1 @ * 0a@@ 0a@ a@ *  "@ @ * ` @) ` )  "f@   f@   f @   " "  "8` "0`  8@@  0@  0 @  0@  0  0@  0  0  0@@  0@ 0  8@@  8@  x@@  p@  0@ 0` @  1f@@   1f@  "f@  x@@ 8@ 8` @ #8@@ !8@ !8` @  x@  p@  0@@ 0@ @ * " @ * a@ 0@@ 0@ 0 @ 0@@  8@  8  8` ta@ ) p@ )  p@ ) 0@@ p@@ 0 @ 0@@ 0@ 0@ p`@ ) p` ) 0@@ 0@ @ p`@ ) p` ) 1`@ ) 1t` ) p@ ) p @ ) p @ ) @@ " @ *  @ * `@ * ` ` @* ` *  @)  p@)  p @)  )  P)  p )  ` )  p` )  p` ) @ * @ *  ` Instructions Application%Page 2J Attachment ޲ Shipping FormoNMP Summary Optional DCDocuments and SettingsmdauserDesktop5- 101 Application New.XLSPage 1Page 2Page 3 Attachment Shipping Form NMP Summary Ave. Analysis Optional InstructionsSheet1YYYYYYYYZAlleganyZ Anne ArundelZBaltimore CountyZCalvertZCarolineZCarrollZCatoctinZ CecilZCharlesZ  DorchesterZ  FrederickZ GarrettZ HarfordZ HowardZ KentZ MontgomeryZPrince George'sZ Queen Anne'sZ St. Mary'sZSomersetZTalbotZWashington CountyZWicomicoZ Worcester5- 101 Application New.XLSPage 1Page 2Page 3 Attachment Shipping Form NMP Summary Ave. Analysis Optional InstructionsSheet1YYYYYYYYZAlleganyZ Anne ArundelZBaltimore CountyZCalvertZCarolineZCarrollZCatoctinZ CecilZCharlesZ  DorchesterZ  FrederickZ GarrettZ HarfordZ HowardZ KentZ MontgomeryZPrince George'sZ Queen Anne'sZ St. Mary'sZSomersetZTalbotZWashington CountyZWicomicoZ Worcester   County;  County;  ;"   ;7Trj0 3 A@@   l"MARYLAND DEPARTMENT OF AGRICULTUREMANURE TRANSPORT PROJECT (APPLICATION/AGREEMENT - LAND APPLICATIONAGREEMENT NUMBERMT For MDA Use SS / FID #DistrictTelephone NumberSNAME and ADDRESS of person to receive check, include farm / corporate name, if any.Type of Manure: For SCD UseSECTION II - TECHNICAL REPORTAMOUNTMILEAGETOTALCost-Share RateEligible State Cost-Share SECTION IV - APPLICANT AGREEMENTPublic Information Notice: The principal purpose for which the information on this application is used is to identify you as one of those persons whom the agency intends to give State Cost-Share funds. If you fail to provide the requested information, the agency may not provide you with State Cost-Share funds. You have a right to inspect, amend, or correct personal information collected by the agency. Much of the personal information collected by the agency is available for public inspection. Manure ConsistencyPercent MoistureUp toUp to / PER TON SOLID0 - 75.9 SEMI-SOLID 76 - 82.9SLURRY 83 - 89.9LIQUID 90 - 99.9PER YARDPER 1000 GALLONSLess Than 25 MilesGreater Than 25 MilesMANURE TRANSPORTEDMANURE CONSISTENCYUNITPER TONUNITS TONS CUBIC YARDS 1000 GALLONSAnalyzing Manure (Per Invoice)Authorized Signature DateSignature of ApplicanttoGeneral Comments:'SECTION V - DETERMINATION OF ELIGIBILTYThe Maryland Department of Agriculture has determined that this application is (is not) eligible for state cost sharing for the estimated amount shown at the right. If not, it is explained in General CommentsSignature (MDA Representative)MDA Estimate of Cost Shares: $SECTION VI - FUND INFORMATIONThe Maryland Department of Agriculture certifies that the agreement for this project is in order, is signed by all parties and is approved.Fund Source(s):Approval Amount $ SECTION VII - AGREEMENT APPROVALThe parities have executed this Application/Agreement, by causing the same to be signed on the day and year first written above.)By: _____________________________________STATE OF MARYLANDDEPARTMENT OF AGRICULTURERSignature (MDA Representative) Date X General Federal  ' AGREEMENT NO. _____________________MT$ MARYLAND DEPARTMENT OF AGRICULTUREMANURE TRANSPORT PROJECT"ATTACHMENT TO COST-SHARE AGREEMENTPROVISIONS FOR LAND APPLICATIONThe Applicant agrees:1)2)cTo comply with all Department biosecurity and public safety requirements, including the following:Cd. Compliance with all Departmental animal health requirements; and3)4)5)To apply manure as a source of plant nutrients according to a state certified nutrient management plan under the following conditions:6)7)8)9)To allow a MDA representative(s) access to the receiving and/or sending site(s) for the purpose of inspection and verification of program compliance.<I have read the above provisions and shall comply with them.f __________________________________ Signature ________ Date #MARYLAND DEPARTMENT OF AGRICULTURE MANURE TRANSPORTATION PROJECTAPPLICANT APPLICANTS NAME:ADDRESS:CITY/STATE/ZIP:PHONE: FARM NAME:NAME:NMP CONSULT NAME:COUNTY:ERECEIVING FARMS (NUTRIENT MANAGEMENT PLANS REQUIRED/ATTACHED) RECEIVING LOCATIONNAME/FARM NAME: ADDRESS: CITY/STATE/ZIP: SHEET # SENDING OPERATION CLAND APPLICATION SHIPPING FORM (103) - TO BE COMPLETED BY APPLICANT 1 OF 1CONSULTANT CERT. #$74.70/1000 gal Total Amount $18.00/tonCost Effectiveness (MDA Use) $6.00/yd RATE PER TON MILEAGE >25 ELIGIBLE RATE$ St. Mary'sAllegany Anne ArundelBaltimore CountyCalvertCarolineCarrollCatoctinCecilCharles Dorchester FrederickGarrettHarfordHowardKent MontgomeryPrince George's Queen Anne'sTalbot WashingtonWicomico WorcesterYESNOSender: Receiver:To have the manure analyzed for nutrient content as directed by the Department before it is transported. To include manure generation/quantity information with the application.Aa. All manure shall be covered while on a public road or highway;b. A truck-mounted or tractor-drawn spreader shall be covered during the transportation of manure from one farm to another unless contiguous;c.Prior to operating on or near another poultry or livestock operation, all transporting and handling equipment used to transport manure shall be cleaned, washed, and disinfected;Either the producer or the receiver of manure, but not both, is eligible to apply for and receive state cost-share assistance. A producer may only apply under a pooling agreement. (See Producer Guidelines)To provide a delivery site for the off-loading of manure that is safe and does not pose any undue environmental risk to water quality. (See Delivery Site Guidelines)If the manure is stockpiled or stored for 6 months or greater, to perform an additional nutrient analysis for manure as close as possible to the plant nutrient application period as provided in a nutrient management plan.e.If hiring another person to transport manure, requiring that person to comply with biosecurity and public safety requirements.a. On fields with soil testing less than 101 for phosphorus on the Fertility Index Value, manure may be used according to a nitrogen-based nutrient management plan;b. On fields with soil testing optimum, or 101 to 150 for phosphorus on the Fertility Index Value, manure shall be applied according to a nutrient management plan using phosphorus as the limiting factor. c. Fields with soil testing 150 or greater for phosphorus on the Fertility Index Value, are not eligible under the Project requirements. A person shall not apply manure.  AGREEMENT# ___________________MTTOTAL TONS/YDS/GAL PAGE 1 of 4 PAGE 2 of 4 PAGE 3 of 4 PAGE 4 of 4Maximum amount: (1) per manure producing operation - $7500.00 annually, (2) per ton - $18.00, (3) per yd - $6.00, (4) per 1000 gal. - $74.70hi Individual Request  Public Land( )( X )SECTION 1 - APPLICATION (103)/Approximate dates manure will be transported: SpringSummerFallManure Available for Transport:*Estimated Amount Used Within One (1) Mile:3Estimated Amount in Storage (time of application): *Applicants Comments/Instructions/Requests:-Estimated Amount Used by Receiving Operation:9SUPPLEMENTAL INFORMATION - SENDING & RECEIVING OPERATION Page 5 of 5>LAND APPLICATION WORKSHEET - RECEIVING OPERATION - NMP SUMMARYAddress:City/State/Zip: Telephone:Manure Analysis:Original Used (attached)RECEIVING FIELDS Account ID #Field #AcresCrop Yield GoalCorn TOTAL Acres Signature - Receiving Operation( X )Allen'sPerdue MountaireTysonWheatHayPastureOatsBarleyAllen's Average AnalysisPerdue Average AnalysisMountaire Average AnalysisTyson Average AnalysisRate of Application*Text Book Analysis UsedOther Manure (103)DairyDAIRY POULTRY LAYERTURKEYHORSEBEEFGallonsTonsUsed Within 1 Mile: Excess Manure Account Id # Type of Manure*:Manure Consistency*:Soil Test Lab #Sorghum* Manure Type, Manure Consistency, and units of measurement, must be consistent with the Manure Type, Manure Consistency, and units of measurements used in the nutrient management plan and Application/Agreement.?Certification: Soil analyses and maps for above fields are attached. This is not a Nutrient Management Plan. The above information comes from my Nutrient Management plan using recommendations for manure as a nutrient source. The plan is on file at my place of business and I understand it may have to be submitted prior to Agreement approval. As indicated above, the manure analysis used to develop the plan is attached unless a< text book analysis is used. If not provided I understand a manure analysis is required to be taken and submitted with my claim for payment. !"E!" District:Manure in Storage:#Nutrient Management Consultant NameCertification NumberConsultant Telephone Plan Date Name - Receiving Operator(s): $ 05010267711Manure Transport Project Application InstructionsJ5) Submit completed Application / Agreement to the Maryland Department of5Agriculture or your local Soil Conservation District.A1) Complete/enter - Social Security Number or Federal ID Number.=2) Complete/enter - Soil Conservation District (county) (*).:3) Complete/enter - Telephone Number. Include area code.Name:11 East West RoadAnytown, MD 999991) Print out attachment.a2) Complete/enter name(s) of Nutrient Management Plan preparer(s) and Certification Number(s) inspaces provided.3) Sign and submit Attachment.%E) SHIPPING FORM (Page 4) - REQUIRED&+1) Complete/enter Applicant's information.^2) Complete/enter Sending Operation information. Only one sending operation per Application.]3) Complete/enter Receiving Farms. Provide property account identification numbers for each[F) NUTRIENT MANAGEMENT PLAN SUMMARY - RECEIVING FARM - (In lieu of the Nutrient Management&58'NPlan being submitted, this Nutrient Management Plan Summary may be submitted.)B1) Complete/enter - Name, Address, City, State, Zip and TelephoneH4) Indicate - Average Analysis Used or Original Analysis Used (attach).$Yield Goal, and Rate of Application.MAIL COMPLETED APPLICATION TO:"Maryland Department of Agriculture@Maryland Agricultural Cost-Share - Manure Transportation Project50 Harry S. Truman ParkwayAnnapolis, MD 214011FOR QUESTIONS AND ADDITIONAL INFORMATION CONTACT:"Norman Astle - Project Coordinator 410-841-5863!MDA Website: www.mda.state.md.us(Animal Manure (103) - Non Poultry Litter^1) Complete/enter - Amount of manure to be transported. Must Select appropriate unit that is.DETERMINATION OF GRANT AMOUNT - ANIMAL MANURES]Statewide flat rates will be allowed for each load of manure transported and manure analyzed.a.Analyzing/testing manureb.Transporting manure+See schedule(s) below, or attached table(s)1operating unit annually (regardless of applicant)5 miles10 miles15 miles20 miles 25 miles25 milesAdd 10 cents/mile/ton* Transporting greater than 25 miles requires weighing at a state certified scale and a weight ticket attached to the chain of custody form.&5. Conversion Factors(.1. 8.3 pounds / gallon manure(,3. 7.5 gallons / cubic foot(*4. 60 pounds / cubic foot(-5. 1.25 cubic feet / bushel( and greater*The actual final payment will be based on the invoice(s) received with Claim for Payment form to determine the final eligible cost not to exceed the established flat rate.Flat rate schedulea.)b.)#Maximum amount per manure producing&2. 1,000 gallons / 4.15 tons* PER TON /FLAT RATE (See Instructions) PAGE 6PAGE 5 Page 6 of 6"Use Additional Worksheet As NeededAcres (page 5)Balance Forward (page 5) Cubic Yards*Amount (acres x rate);Other Manure (103) - Use Additional Worksheet As Needed+Application Period:/A) APPLICATION - SECTION I (Page 1) - REQUIRED&$0B) APPLICATION - SECTION II (Page 1) - REQUIRED&%KC) PAGE 2 - SUPPLEMENTAL INFORMATION and APPLICANTS COMMENTS, - OPTIONAL &BTconsistent with units in the nutrient management plan for the receiving operation. y2) Complete/enter - Mileage, estimate mileage to the nearest 5 mile increment. Select (*) - 5, 10, 15, 20, or 25 miles.75) Complete/enter type of manure to be transported. (*)D1) Space has been provided to indicate approximate transport dates.2) Space has been provided to indicate the manure in storage at the sending operation, and the estimated amount of manure used within one (1) mile by the sending operation. V3) Complete/enter application period - Sending Operation - Spring, Summer, or Fall (*) parcel of land receiving manure.O4) Complete/enter amount of manure (tons/gallons) to be received at each farm.TONS/GAL (NMP):5) Print and submit.l3) Complete/enter Nutrient Management Plan Consultant Name, Certification Number, Telephone, and Plan date.B5) Complete/Select - Application Period, Spring, Summer, or Fall.Y6) Complete/enter amount of manure in storage and amount of manure used within one mile.`7) Complete/enter - Account ID Number (*), Field Number, Soil Test Lab Number, Acres, Crop (*),8) Print, Sign, and submit.<D) ATTACHMENT - TO COST-SHARE AGREEMENT (Page 3) - REQUIRED&1MARCH 2004 MTP Manual *2) Complete/enter - District (SCD)/County3Name of Nutrient Management Plan preparer (sending) State Cert. #If manure is being transported less than 1 mile from a production or storage site to the applicants farm that: (1) the manure is being transported to a farm not owned or managed by the producer; (2) the land receiving the manure is not phosphorus over enrAccording to a nutrient management plan, to apply stackable manure within 7 days of its receipt, and apply nonstackable manure upon receipt, or stockpile or store manure in a manner that protects it from rainfall, runoff or leaching. (See Stockpiling Guid5Name of Nutrient Management Plan preparer (receiving)k4) Complete/enter the estimated amount of manure used by the receiving farm(s)/operation (see NMP Summary)&5) Print and submit with Application.c2) For your convenience drop down boxes are provided in certain cells marked with an asterisk (*).23) After completing, print out pages 1 through 5.SomersetBeef Poultry LayerHorseSwineTurkeySheepOtherApplicants Name: Farm Name:City/State/Zip See example below.Doe Farm@John W. Smith (and company if necessary) F4) Complete/enter - Name, Farm Name, Address, City, State, and Zip. L6) Indicate Sender/Receiver/or both when transporting within operation (*).ACCOUNT ID No. # : COUNTY(*): COUNTY (*):bPlease Note: Use Account ID No. # for the actual parcel of land producing or receiving the manure.General InstructionsDetailed Instructions3) Print, sign and submit.Instructions ContinuedD9) Attach soil analysis and maps for those fields receiving manure.& One Analysis (1)/$ (Per Invoice)ahttp://www.mda.state.md.us/resource_conservation/financial_assistance/manure_management/index.phpDocument Address SEPT 2007SEPT 2007 MTP D) Completion of this Application Agreement may require the assistance of a nutrient management consultant and/or assistance from the local soil conservation district.OC) The Applicant may be an operation transporting manure within the operation. gB) This application /Agreement can only be used by an operation receiving manure for land application. $Use of this Application/Agreement - zA) This Application/Agreement is for the transport of manure (non-poultry litter) under the Manure Transporation Project. MDA - 101 - APPL REV 8/2007MDA - 103 - APPL REV 8/2007MDA - 103 - APPL REV 8/2007 [(Designated Chairman, Chairman's Designee, or Maryland Dept. of Agriculture representative)/The Maryland Department <} of Agriculture, or, the9Soil Conservation District has reviewed this referral andFor MDA or District Use2 SECTION III - TECHNICAL DETERMINATIONfinds it / does not find it adequate and appropriate for this program. If not, see explanation under General Comments. No determinations have been made about the appropriateness of receiving sites not within the State or District jurisdictions.lCERTIFICATION: I request cost-sharing under this program to solve a nutrient management/water quality problem. I have read and agree to adhere to requirements set forth under (1) COMAR 15.20.05 and (2) this agreement which includes the Attachment. I understand that I shall not proceed with this project until I have received a letter of approval and a signed and dated copy of my agreement from the Maryland Department of Agriculture (Department). If I fail to comply with the requirements set forth under COMAR 15.20.05 and this agreement, the Department with no obligation to pay the applicant can cancel the agreement and any payments already made will be forfeited. I agree that the Department, or, Soil Conservation District, their officers, agents, and employees are not responsible for any damage to life and property due to my activities, or those of my operation s officers, agents and employees, in connection with this Agreement. Furthermore, I agree the Department, or, Soil Conservation District shall be held harmless by me from any liability resulting from the removal, transportation, or use of animal waste.D4) Applicant's signature is required on page 1, page 3, and page 5.1) Applicant will complete green shaded cells of Application / Agreement. 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