SWCD File Code 91.3 CS-2
(emergency form 5/25/11)
Ohio Agricultural Pollution Abatement Program
Emergency Cost Share Agreement
Name of owner or operator
City, State, Zip Telephone number
State cost share not to exceed: $ 500
I (we), the undersigned owner(s)/operator(s), request state cost sharing to help pay for the cost to haul and dispose
of liquid manure at a wastewater treatment facility or at another manure storage structure with adequate storage
capacity. I (we) understand and agree that:
1. A representative of the SWCD must validate verify manure storage levels and estimate daily manure and
wastewater production as needed to determine eligibility.
2. Operations with less than 120 days storage capacity will not be considered eligible for assistance, unless
there is an extenuating circumstance. These situations (less than 120 days storage) will require individual
approval by the OSWCC and DSWR.
3. Public cost sharing will not exceed 50 percent of the actual cost up to a maximum amount of $500.
4. All items of cost upon which reimbursement will be based must be supported by receipts for payments
made to vendors and/or a list of owner/operator equipment, and cost. The district administrator or an
appropriate designee of the Board of Supervisors shall verify all such supporting information as proper and
5. Any representative of the district shall have the right of ingress and egress to my land for the purpose of
fulfilling this agreement.
I hereby agree to the aforementioned terms and conditions.
Soil and Water Conservation District:
I have reviewed this request and can validate the need for emergency funding for the owner/operator listed above
(District Administrator, or Designee of the District) (Date)
Ohio Soil & Water Conservation Districts
Ohio Department of Natural Resources - Division of Soil & Water Resources