June 2003 Nutrient Management Protocol for Ontario Regulation 267/03 Made under the Nutrient Management Act, 2002

Part 15 – Forms

Table of Contents

  1. Farm Unit Declaration Form When NMAN Workbook is Used
  2. Nutrient Management Strategy or Plan Certification Form
  3. Application Agreement
  4. Broker Agreement with Generator
  5. Broker Agreement with Receiver
  6. Nutrient Transfer Agreement
  7. Nutrient Management Strategy for Non-Agricultural Operation Generating Non-Agricultural Source Material Form

15.1a Farm Unit Declaration Form for Use When NMAN Software is Used to Complete Nutrient Management Strategy and Plan

A Farm Unit as defined by the Nutrient Management Act, 2002 Ontario Regulation ***/03 is the basis for a Nutrient Management Strategy and/or Nutrient Management Plan. All parts of the Nutrient Management Strategy or Plan are with respect to the land base and any agricultural facilities declared in that Farm Unit and not to any other land base or agricultural facilities. A farmer may declare more than one farm unit within the agricultural operation, provided each separate Farm Unit fits the definition. There is no minimum land ownership requirement for the land included in the farm unit but the land must be owned or controlled by the same person if it is part of the landbase of a single farm unit. Application Agreements are required for property that is included in the Farm Unit but not owned by the farmer. There is no maximum number of Nutrient Units per Farm Unit.

A: Contact Information

Displayed in Page 1 or 2 of the Nutrient Management Approval generated by NMAN.

B: Location of all the Generating and Storage Facilities that are part of this Farm Unit

Displayed in Page 1 or 2 of the MSTOR Printout generated by NMAN.

C: Location and Identification of Land that is part of this Farm Unit

Displayed in Page 1, 2 and/or 3 of the NMAN Application for Nutrient Management Approval generated by NMAN.

D: Declaration

I, _________________________________________ (farm unit operator or authorized agent if owned by a corporation) declare that the facilities and property referred to on this form comprise the entirety of this Farm Unit. I acknowledge the requirement to complete a nutrient management plan and/or strategy, and that such nutrient management strategy and/or plan shall include all of the lands identified on this form.

I hereby warrant that the information contained on this form is true, and that I have authority to complete this document.

Indicate whether the operation that this farm unit is in, is either

___ Corporation Name:

___ Division of a Corporation, Name:

___ Partnership, Name Partners:

___ Sole Proprietorship, Name of business:

Farm Unit Operator/ Authorized Agent (print):

Signature:

Date:

Witness (print):

Signature:

Date:

15.1b Farm Unit Declaration Form for Use When NMAN Workbook is Used to Complete Nutrient Management Strategy or Plan

A Farm Unit as defined by the Nutrient Management Act, 2002 Ontario Regulation ***/03 is the basis for a Nutrient Management Strategy and/or Nutrient Management Plan. All parts of the Nutrient Management Strategy or Plan are with respect to the land base and any agricultural facilities declared in that Farm Unit and not to any other land base or agricultural facilities. A farmer may declare more than one farm unit within the agricultural operation, provided each separate Farm Unit fits the definition. There is no minimum land ownership requirement for the land included in the farm unit but the land must be owned or controlled by the same person if it is part of the landbase of a single farm unit. Application Agreements are required for property that is included in the Farm Unit but not owned by the farmer. There is no maximum number of Nutrient Units per Farm Unit.

A: Contact Information

Operation Identifier (if applicable):

Farm Unit Operator:

Mailing Address:

Telephone and Email Address:

B: Location of all the Generating and Storage Facilities that are Part of this Farm Unit

Type of facility Lot Concession Township County
         
         
         
         
         

C: Location and Identification of Land that is Part of this Farm Unit

Give each farm or field a unique name that will also be used the nutrient management plan for this farm unit.

Farm or Field Name:

Lot, Concession:

Township, County:

Former Township:

Roll Number:

911 Location (if applicable):

Property Identification Number:

Tillable Acreage:

___ Not owned, application agreement attached

Farm or Field Name:

Lot, Concession:

Township, County:

Former Township:

Roll Number:

911 Location (if applicable):

Property Identification Number:

Tillable Acreage:

___ Not owned, application agreement attached

Farm or Field Name:

Lot, Concession:

Township, County:

Former Township:

Roll Number:

911 Location (if applicable):

Property Identification Number:

Tillable Acreage:

___ Not owned, application agreement attached

___ More facilities listed on the back of this form.

___ More land listed on the back of this form.

D: Declaration

I, _________________________________________ (farm unit operator or authorized agent if owned by a corporation) declare that the facilities and property referred to on this form comprise the entirety of this Farm Unit. I acknowledge the requirement to complete a nutrient management plan and/or strategy, and that such nutrient management strategy and/or plan shall include all of the lands identified on this form.

I hereby warrant that the information contained on this form is true, and that I have authority to complete this document.

Indicate whether the operation that this farm unit is in, is either

___ Corporation Name:

___ Division of a Corporation, Name:

___ Partnership, Name Partners:

___ Sole Proprietorship, Name of business:

Farm Unit Operator/ Authorized Agent (print):

Signature:

Date:

Witness (print):

Signature:

Date:

15.2 Nutrient Management Strategy or Plan Certification Form

Contact Information:

Name of Operator:

Address:

Telephone:

Operation Identifier:

Nutrient Management Strategy or Plan Number:

Notice of Collection:

Personal information provided in the application is collected under the authority of the Nutrient Management Act, 2002, Ontario Regulation ***/03 s. 4.1(1). It will be used for the review, approval, enforcement and audit of the strategy or plan, as the case may be. The information may be made available to external experts contracted by OMAF for advice during review and approval or to Ministry of the Environment for advice during review and approval or for enforcement purposes. A public record of approved plans will be available to the public by publication in print or over the World Wide Web. The public record will consist of the following information for each farm unit holding an approved nutrient strategy or plan: 1) owner of the farm unit and developer of the strategy or plan; 2) properties included in the declared farm unit, which will be identified by lot & concession, or latitude and longitude; 3) type, source and annual amount of the nutrient generated; 4) days of storage; and, 5) the proportion of the nutrient applied to the farm unit and the proportion moved to other properties. Data from plans and strategies may be aggregated without personal identifiers and made available to researchers for evaluation of the program and other matters related to nutrient and environmental management that may be in the public interest. Questions about this collection should be directed to:

Manager, Approvals,
Nutrient Management Branch,
Ministry of Agriculture and Food,
1 Stone Road West
Guelph, ON N1G 3S4
Phone: 519-826-6368

Provision of False Information in this Application:

Any false or misleading information submitted by the applicant in this document may result in the invalidation of any approvals or permits granted, and prosecution in accordance to the provisions of the Nutrient Management Act, 2002.

Declaration

Applicant declaration

I, _______________________________[the applicant (farm unit operator or authorized agent if owned by a corporation)], certify

(a)  that the information contained in this application provides an accurate description of the existing and proposed operation in all material respects over the time period covered by this plan or strategy;

(b)  that I understand that in the course of the administration of the Act, the ministry may provide the information contained in this application to external agents for review and analysis, and authorize the ministry to provide this information to its external agents, and authorize its external agents to collect this information from the ministry

and

I, _______________________________,

___ authorize

or

___ do not authorize

_________________________to act as my agent for the purposes of obtaining approval for this application, and may provide the ministry, or its agents, any information required in the review of this application.

Name (print):

Signature:

Date:

Declaration of Individual who prepared the plan

I, ____________________________, hereby certify that based on relevant information provided in good faith and excluding unforeseen or uncontrollable circumstances, the recommendations contained in this application will, if implemented, result in acceptable management practices in accordance to the regulations and protocols under the Nutrient Management Act, 2002.

Name (print):

Signature:

Date:

15.3 Application Agreement

Name of Land Owner:

Address:

Telephone:

Name of Farm Unit Operator/Authorized Agent if a Corporation:

Operation Identifier:

Nutrient Management Plan Number:

This agreement, between the parties named above, allows for the following fields to be included in the farm unit operator’s Farm Unit Declaration and for application of manure to these fields under the farm unit’s nutrient management plan.

List each field/section under this agreement:

Field/ Section Lot Concession Township County Tillable Acres Roll Number
             
             
             
             

___ There are more fields listed on the back of this form.

I,_________________________ (landowner) give permission to (farm unit operator/authorized agent) to incorporate the above lands into Nutrient Management Plan #__ (to be added by Ministry on submission). I also give permission to the farm unit operator/authorized agent to do soil sampling on the properties listed to determine the condition of the soil. I also agree that the land identified in this agreement will not be used for the application of any other prescribed material, originating from any other operation, including my own (if I have any) during the term of this agreement. This agreement shall be in force for a minimum period of one (1) year, commencing on ________________ and ending on ________________. Pollution liability insurance will be carried by (farm unit operator/ authorized agent) to cover spill cleanup and liability.

Land Owner (print):

Signature:

Date:

Farm Unit Operator/Authorized Agent (print):

Signature:

Date:

Witness (print):

Signature:

Date:

Note: Permission to use these lands is required from all property owners listed on the title to the land. For properties owned by more than one person, permission may be given by additional owners in the form of a signature on this form or a signed letter accompanying this form.

15.4 Broker Agreement with Generator

Broker

Name and Operation Identifier:

and

Generator

Name and Operation Identifier:

Strategy Approval Number:

This agreement, between the parties named above, is for the transfer of the prescribed material identified as:

___ Farm Animal Manure

___ Washwaters from Agricultural Operations

___ Runoff from Livestock Yards or Manure Storage Factilities

___ Organic Materials Produced by Intermediate Handlers (ie Compost)

___ Biosolids (ie municipal sewage, pulp and paper sludge)

The quantity being transferred is:

Type of Livestock at the Generating operation (if applicable):

Number of Nutrient Units Generated at the Generating operation in one year:

The Parties to this Agreement Agree as Follows:

This agreement shall be in force for a minimum period of one (1) year commencing

__________________________ and ending ___________________________.

The terms of this agreement shall strictly apply to the present Broker. Should the Broker use the nutrient in a manner, which is demonstrated to cause environmental harm, the agreement ceases to apply.

The nutrient included in this agreement will be managed under a nutrient management strategy or plan.

Generator Name (print):

Signature:

Date:

Broker Name (print):

Signature:

Date:

Witness Name (print):

Signature:

Date:

15.5 Broker Agreement with Receiver

Broker

Name and Operation Identifier:

and

Receiver

Name and Operation Identifier:

Strategy or Plan Approval Number:

This agreement, between the parties named above, is for the transfer of the prescribed material identified as:

___ Farm Animal Manure

___ Washwaters from Agricultural Operations

___ Runoff from Livestock Yards or Manure Storage Facilities

___ Organic Materials Produced by Intermediate Handlers (ie Compost)

___ Biosolids (ie municipal sewage, pulp and paper sludge)

The quantity being transferred is:

Type of Livestock at the receiving operation:

Number of Nutrient Units Generated at the receiving operation in one year:

The Parties to this Agreement Agree as Follows:

This agreement shall be in force for a minimum period of one (1) year commencing

__________________________ and ending ___________________________.

The terms of this agreement shall strictly apply to the present Broker. Should the Broker use the nutrient in a manner, which is demonstrated to cause environmental harm, the agreement ceases to apply.

The nutrient included in this agreement will be managed under a nutrient management strategy or plan.

Receiver Name (print):

Signature:

Date:

Broker Name (print):

Signature:

Date:

Witness Name (print):

Signature:

Date:

15.6 Nutrient Transfer Agreement

Generator

Name and Operation Identifier:

Strategy Number:

and

Receiver

Name and Operation Identifier:

Strategy or Plan Number (if applicable):

This agreement, between the parties named above, is for the transfer of the prescribed material identified as:

___ Farm Animal Manure

___ Washwaters from Agricultural Operations

___ Runoff from Livestock Yards or Manure Storage Facilities

___ Organic Materials Produced by Intermediate Handlers (ie Compost)

___ Biosolids (i.e. municipal sewage, pulp and paper sludge)

The quantity being transferred is:

The Parties to this Agreement Agree as Follows:
  • The receiver will manage these nutrients in its nutrient management strategy or plan, if required by the Nutrient Management Act, 2002 Ontario Regulation ***/03.
  • The receiver, if a farm unit operator, will include the land that these materials are applied to in its farm unit and on its Farm Unit Declaration, if required by the Nutrient Management Act, 2002 Ontario Regulation ***/03.
  • The Generator will include these prescribed materials in its nutrient management strategy.
  • Both parties will include this agreement in their nutrient management strategy and/or plan, if required by the Nutrient Management Act, 2002 Ontario Regulation ***/03.
  • The Generator and the Receiver warrant that between them there is adequate storage for these prescribed materials that meets the requirements for construction and siting in Part VIII of the Regulation, if required by the Nutrient Management Act, 2002 Ontario Regulation ***/03.
  • The terms of this agreement shall strictly apply to the present Receiver. Should the Receiver use the nutrient in a manner, which is demonstrated to cause environmental harm, the agreement ceases to apply.

This agreement shall be in force for a minimum period of one (1) year commencing

__________________________ and ending ___________________________ .

Generator Name (print):

Signature:

Date:

Receiver Name (print):

Signature:

Date:

Witness Name (print):

Signature:

Date:

Form 15.7 Nutrient Management Strategy for Non-Agricultural Operation Generating Non-Agricultural Source Material Form

If you are a nutrient generator of material intended for land application, you must submit a Nutrient Management Strategy to the Ministry of the Environment, Environmental Assessment and Approvals Branch, for approval every five years. In addition you are responsible for a documented annual update that must be retained on site.

Generator Responsibilities

Nutrient Management Strategy: Prepare and submit Part I through Part V.

Annual Strategy: Complete Part VI annually. This is a planned strategy of activities for the year. Submit Year One with Nutrient Management Strategy. Prepare Year Two through Year Five annually and retain on site with Nutrient Management Strategy.

Annual Report: Complete Part VII and Part VIII within 60 days of each year end and retain on site with Nutrient Management Strategy. These reports include the actual annual activities that were carried out reported at year end.

Part I: Facility Description and Approval Information

Facility Name:

Facility Address (physical location) (street number, name, city/town):

Telephone Number (including area code):

Facility’s Contact Name (i.e. person responsible for NMS):

Total Volume of Materials Produced at Facility (imperial gallon/day or m3/day or wet tonnes/year):

Description of Operations:

I, the undersigned hereby certify that, based on relevant information provided in good faith and excluding unforeseen or uncontrollable circumstances, the recommendations contained in the attached strategy are compliant with the Nutrient Management Act, 2002.

Officer Name (please print):

Officer Title:

Officer Signature:

Date (dd/mm/yy):

Date Submission Received (dd/mm/yy):

Date of Approval (dd/mm/yy):

Identifier Number:

Terms and Conditions of the Approval of this Nutrient Management Strategy:

1. This strategy expires on ____________________(dd/mm/yy)

In accordance with Section 9 of the Nutrient Management Act, R.S.O. 2001, Part 3, you may by written notice served upon me and the Environmental Review Tribunal within 15 days after receipt of this Notice, require a hearing by the Tribunal. Subsection 9(6) of the Nutrient Management Act, provides that the Notice requiring the hearing states:

  1. The portions of the certificate, licence, approval or order in respect of which the hearing is required; and
  2. The grounds on which the applicant for the hearing intends to rely at the hearing. 2002, c. 4, s. 9(6).

The Notice should also include:

  1. The name of the appellant;
  2. The address of the appellant;
  3. The Nutrient Management Strategy unique identifier number;
  4. The date of the Nutrient Management Strategy approval;
  5. The name of the Director;
  6. The municipality within which the works are located.

And the Notice should be signed and dated by the appellant.

This Notice must be served upon:

The Secretary*
Environmental Review Tribunal
2300 Yonge Street, 12th Floor
P.O. Box 2382
Toronto, Ontario
M4P 1E4

and

The Director
Section 2, Nutrient Management Act
Ministry of the Environment
2 St. Clair Avenue West, Floor 12A
Toronto, Ontario
M4V 1L5

*Further information on the Environmental Review Tribunal’s requirements for an appeal can be obtained directly from the Tribunal at:

Tel: (416) 314-4600, Fax: (416) 314-4506 or www.ert.gov.on.ca

I, the undersigned, have reviewed the Nutrient Management Strategy and approve that it meets the nutrient management review criteria of the Ontario Ministry of the Environment.

Director Name (please print):

Director Signature:

Date (dd/mm/yy):

Part II: Material Description and Storage Information

Type(s) of Material Produced (e.g. sewage biosolids, pulp and paper biosolids,  Biosolids Utilization Committee recommended materials) Description of Material (e.g. solid, liquid) Average Annual Volume for Period of Strategy (imp. gal., m3, wet tonnes) Storage
On-site T Off-site T Off-site, list physical address of each permanent storage facility (transfer station) Storage Capacity (imp. gal., m3, wet tonnes)
             
             
             
             
             
             
             
             
             
             

Part III: Projected Five-Year Strategy for Non-Agricultural Source Material Generated

Destination of Material Volume (imp. gal., m3, wet tonnes)
Year 1 Year 2 Year 3 Year 4 Year 5
Land Application          
Landfill Disposal          
Incineration          
Processing (e.g. composting, pellets, etc.)          
Other (e.g. new technology)          
Total          

If volumes are projected to change by 20% or more between years, describe why this has occurred:

Part IV: Nutrient Analysis of Material

Provide a strategy for the analysis of materials that includes:

  • sampling of materials for metals and pathogens;
  • monitoring and analysis of results and record keeping; and
  • providing required data to haulers.

The sampling strategies must meet or exceed the standards established in the Regulations and Protocols. (Analysis results are to be retained on site).

Part V: Contingency Plan

A written contingency plan is required that outlines alternative actions in the event that the strategy cannot be followed.

For spills, non-agricultural facilities are subject to Regulation 347 and Part IX of the Environmental Protection Act.

Alternate Storage Contingency Plan:

Alternate Disposal Contingency Plan:

Part VI: Destination of Material

One sheet for each Hauler. Add more if required
Land Application (Annual)

Year of Strategy (e.g. 2003, Year 1):

Name of Hauler Company:

Broker/Hauler Agreement (Yes or No):

System C of A Number or Licence Number:

Site Site C of A Number or NMP Number, if available Area for Application (acres/hectares) Application Rate (imp. gal., m3, wet tonnes per acre/hectare) Total Volume to be Applied (imp. gal., m3, wet tonnes)
1        
2        
3        
4        
5        
6        
7        
8        
Landfill Disposal (Annual)

Year of Strategy (e.g. 2003, Year 1):

Total Volume to be sent to Landfill (imp. gal., m3, wet tonnes):

Landfill Site (name and address):

Incineration (Annual)

Year of Strategy (e.g. 2003, Year 1):

Total Volume to be Disposed (imp. gal., m3, wet tonnes):

On-site (please T):

Off-site Address:

Processing Material (Annual)

Year of Strategy (e.g. 2003, Year 1):

Total Volume to be Disposed (imp. gal., m3, wet tonnes):

Describe Type of Process (e.g. composting, pellets, etc.):

On-site (please T):

Off-site Address:

Other Management Methods (Annual)

Year of Strategy (e.g. 2003, Year 1):

Total Volume to be Disposed (imp. gal., m3, wet tonnes):

Describe Method (e.g. new technology):

On-site (please T):

Off-site Address:

Part VII: Annual Report of Management of Material

One sheet for each Hauler. Add more if required
Land Application Report (Annual)

Year End for Strategy Year (e.g. 2003, Year 1):

Name of Hauler Company:

Broker/Hauler Agreement (Yes or No):

System C of A Number or Licence Number:

Site Site C of A Number or NMP Number, if available Total Area Applied (acres/hectares) Actual Application Rate (imp. gal., m3, wet tonnes per acre/hectare) Total Volume Applied (imp. gal., m3, wet tonnes)
1        
2        
3        
4        
5        
6        
7        
8        
Landfill Disposal Report (Annual)

Year End for Strategy Year (e.g. 2003, Year 1):

Total Volume to Landfill (imp. gal., m3, wet tonnes):

Landfill Site (name and address):

Incineration Report (Annual)

Year End for Strategy Year (e.g. 2003, Year 1):

Total Volume Disposed (imp. gal., m3, wet tonnes):

On-site (please T):

Off-site Address:

Processing Material Report (Annual)

Year End for Strategy Year (e.g. 2003, Year 1):

Total Volume Disposed (imp. gal., m3, wet tonnes):

Describe Type of Process (e.g. composting, pellets, etc.):

On-site (please T):

Off-site Address:

Other Management Methods Report (Annual)

Year End for Strategy Year (e.g. 2003, Year 1):

Total Volume Disposed (imp. gal., m3, wet tonnes):

Describe Method (e.g. new technology):

On-site (please T):

Off-site Address:

Part VIII: Report on Five-Year Strategy for Non-Agricultural Material Generated

Destination of Material  Volume (imp. gal., m3, wet tonnes)
Year 1 Year 2 Year 3 Year 4 Year 5
Land Application          
Landfill Disposal          
Incineration          
Processing (e.g. composting, pellets, etc.)          
Other (e.g. new technology)          
Total          

If volumes changed by more than 20% between years, describe why this has occurred:

 


For more information:
Toll Free: 1-877-424-1300
E-mail: ag.info.omafra@ontario.ca
Author: OMAFRA Staff
Creation Date: 30 June 2003
Last Reviewed: 30 June 2003