Office Use Only:
ID # _____________________
General Information:
Landowner: _______________________________ County: _____________________________ Date: _______________
Cost Share Programs: _______________________________________________________________________________
Comprehensive Nutrient Management Plan:
Need
Complete
In Process
To be Updated
Planned Completion Dates for CNMP: __________________________________________________________________
If available, please attach copies of all nutrient management planning activities
completed to date and documentation of all work completed to date on the farm
(including I&E's, Survey, Soils, As-builts, etc.)
Type of Operation: Dairy Beef Hogs Poultry Other ____________________
Livestock: ___________ Class ___________ # Animals ___________Average Weight
(lbs) ___________ Animal Units
___________ Class ___________ # Animals ___________Average Weight (lbs) ___________
Animal Units
___________
Class ___________ # Animals ___________Average Weight (lbs) ___________ Animal
Units
Has an I&E been performed at the site?
Yes or
No (if Yes please attach copy if not at the NRCS Technical Center)
Technical Assistance:
Technical Assistance Requested for: CMNP Planning CNMP Implementation
If CNMP Planning Describe Technical Assistance Requested and components for assistance requested (i.e. I&E,
Calculations, Mapping, etc.) ________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
If CNMP Implementation Describe Technical Assistance Requested (Practice Codes, etc.) and Components for assistance
requested (i.e. I&E, Survey, Design, CQA, etc.) _________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
___________________________________ ________________
Signature Date