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FIELD OFFICE #2 2300 15th St SW, Mason City, Iowa 50401
641-424-4073 / FAX 641-424-9342 [email protected] DNR Form 542-0627
Construction Certification - for Confinements Facility ID#:
When permitted construction has been completed (>1000 AU) and prior to populating the new, expanded or modified building(s) and prior to storing any manure in the new, expanded or modified formed manure storage structure(s), a written “authorization to use” must be obtained from the Iowa DNR. Complete this and the attached concrete wall detail, sign and date it, and mail, fax or email it to Paul Petitti or Cindy Garza, the contact information is at the bottom of this page. These forms must be completed to verify that all construction met DNR concrete rules and construction permit provisions were met.
Permittee: Name of Operation:
Construction of the following permitted structure(s) The type and number of manure structures as listed in permit.
is completed including the following checked items:
Construction was in accordance with the concrete design standards of 567 IAC 65.15(14) and approved CDS. The attached concrete wall detail certifications were completed, signed and are attached. All form ties were “Non removable”.
Construction was in accordance with the drainage tile removal standards of 567 IAC 65.15(1) and either, No tile was found during excavation of the permitted structure(s), or Tile was found and properly rerouted.
Construction was in accordance with the minimum required separation distances of Iowa Code 2003 Sections 459.202 and 459.310. Furnish the completed DNR Well Record Form and a site map showing the as built dimension from the well to the nearest confinement structure. Required vertical separation distance was maintained between karst bedrock or alluvial aquifer. The DNR Field Office was notified prior to initial concrete pour for the manure storage structure(s).
Check one each of the next 2 sets of boxes: A licensed professional engineer submitted his determination of the average annual high water table at the site,
Or A drainage tile system has been installed around the base of the manure storage structure(s).
If drainage tile line(s) were installed: To effectively lower the groundwater table, the drain tile must outlet either by:
Gravity outlet. or Mechanical outlet (sump pump). and
A device to allow monitoring of the water in the tile and a device to allow shutoff of the drainage tile lines have been installed.
Or The drainage tile lines have a surface outlet accessible on the property.
A site map is included showing the location of the tile outlet(s) or monitoring point(s).
Pit Fan Transitions were installed: or Pit Fan Transitions were not installed: Transitions are stainless steel Transitions were sealed to exterior concrete wall All transition anchors were installed Transitions are water tight up to the maximum manure level.
Bathrooms & Laundry facilities were plumbed to a septic tank. (Cannot be tied into manure storage structures) All Permit required Master Matrix items have been installed or completed. (Landscaping, filters, etc.)
Comments:
I hereby certify that the above checked have been completed as required by Permit No: CP-A202 -
Signature: Date:
Title:
FIELD OFFICE #3 1900 N Grand, Gateway North, Ste E17, Spencer, Iowa 51301 712-262-4177 / FAX 712-262-2901 [email protected] 2/2020 cmc
Phone:
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PROVIDE 2" MINIMUM COVER ON ALL REINFORCING
GROUND SURFACE SLOPED TO DRAIN AWAY
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GRANULAR BACKFILL MATERIAL, MINIMUM HALF THE WALL HEIGHT
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3" DRAIN LOCATION TILE DAYLIGHTS IN ___ CORNER OF
MIN.
BARN OR TILE TIES INTO EXISTING FIELD TILE ON ___ _ SIDE OF BARN
FOOTING WIDTH MIN. TWICE FOOTING THICKNESS, CENTER FOOTING ON WALL
WALLS WHERE VEHICLES ARE
ALLOWED WITHIN 5 FEET
VERTICAL STEEL # __ BARS@ " ___ o.c. GRADE __ _
HORIZONTAL STEEL
# __ BARS@ " ___ o .. c.GRADE __ _
#4 DOWELS
WATERSTOP INSTALLED __ _
2-#4 CONTINUOUS
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FLOOR SLAB REINFORCING
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# __ BARS@ " ___ o.c. EACH WAY
ALTERNATE DOWEL CONFIGURATION
I CERTIFY THAT THE INFORMATION ON THIS SHEET IS ACCURATE:
PRINT NAME-----,-------
SIGN NAME
COMPANY
DATE
DNR Form 542-0627
TOP OF WALL
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( LATERAL BRACING
PROVIDE 2" MINIMUM COVER ON ALL REINFORCING
GROUND SURFACE SLOPED TO DRAIN AWAY
i----- MIN. WALL WIDTH __ "
GRANULAR BACKFILL MATERIAL, MINIMUM HALF THE WALL HEIGHT
THE MONITORING PORT AND VALVE ARE LOCATED IN
CORNER OF BARN OR N/A IF TILE DAYLIGHTS
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DRAIN LOCATION TILE DAYLIGHTS IN ___ CORNER OF
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BARN OR TILE TIES INTO EXISTING FIELD TILE ON ___ _ SIDE OF BARN
FOOTING WIDTH MIN. TWICE FOOTING THICKNESS, CENTER FOOTING ON WALL
WALLS WHERE NO VEHICLES ARE
ALLOWED WITHIN 5 FEET
VERTICAL STEEL # __ BARS@ " ___ o.c. GRADE __ _
HORIZONTAL STEEL # __ BARS@ " ___ o .. c. GRADE __ _
#4DOWELS
WATERSTOP INSTALLED __ _
2-#4 CONTINUOUS
4
FLOOR SLAB REINFORCING
. a:: �o �o = ...I IO U.
# __ BARS@ " ___ o.c. EACH WAY
ALTERNATE DOWEL CONFIGURATION
I CERTIFY THAT THE INFORMATION ON THIS SHEET IS ACCURATE:
PRINT NAME _________ _
SIGN NAME
COMPANY
DATE
DNR Form 542-0627
