Intake Form Thank you for contacting the Socially Responsible Agriculture Project (SRAP). We are a nonprofit organization with a focus on factory farm issues. We do not solicit work, so your request for help is necessary for us to work with your community. We will never charge you for our services, but as a nonprofit organization, we greatly appreciate your support and contributions. To provide assistance, all we need from you is a commitment that you are willing to organize your community. We will provide you with tools to empower your community. We do ask that you keep our internal strategy communications confidential and that you not use SRAP's name or logo on any public outreach materials without our permission. Please note that SRAP cannot offer legal advice and no guidance we provide should be taken as legal advice. We do not oppose any factory farm operations for reasons based on immigration status, race, religion, etc. Please answer the following questions as best you can, and we'll connect you with one of our team members. If you cannot provide an answer, leave it blank or put "NA". *Fields with asterisks are required. Today's Date* First Name* Last Name* Email* Phone* Address (# and Street)* City* State/Province* ALAKAZAR CACOCTDE FLGAHIID ILINIAKS KYLAMEMD MAMIMNMS MOMTNENV NHNJNMNY NCNDOHOK ORPARISC SDTNTXUT VTVAWAWV WIWY Postal Code* County* Are there any time sensitive issues (meetings, deadlines, etc.)?* Tell us about the operation you are facing Name of CAFO Name of Operation or Owner Name of Integrator (Tyson, Perdue, etc.) Proposed or Existing Operation* Proposed Existing Proposed Expansion Construction Underway Operation Type Biogas/Digester Facility Hog Operation Hog Operation w/ Digester Dairy Operation Dairy Operation w/ Digester Poultry Operation - Broiler Poultry Operation - Layer Poultry Operation w/ Digester Turkey Beef Cattle Feedlot Beef Cattle Operation w/ Digester Processing Plant/Slaughterhouse Waste Facility/Land Application Multispecies Other If other, please describe Is there a biogas digester? Yes No Proposed Under Construction Unsure Animal # of Main Species 0-500 500-1,000 1,000-5,000 5,000-10,000 10,000-20,000 20,000-50,000 50,000-100,000 100,000-150,000 150,000-200,000 200,000-250,000 250,000-300,000 200,000-450,000 450,000-500,000 500,000-600,000 600,000-700,000 700,000-800,000 800,000-900,000 900,000-1,000,000 1,000,000-2,000,000 2,000,000-3,000,000 3,000,000-4,000,000 4,000,000-5,000,000 5,000,000+ None Unknown Exact # of Main Species Type of Waste Storage Digester Dry Litter Lagoon Stockpiling Underground Pit Unknown Wet Litter System or Combined Dry/Wet System Operation Street Address Operation City* Operation State* ALAKAZAR CACOCTDE FLGAHIID ILINIAKS KYLAMEMD MAMIMNMS MOMTNENV NHNJNMNY NCNDOHOK ORPARISC SDTNTXUT VTVAWAWV WIWY Operation County* Operation Zip Code GPS Coordinates (Latitude and Longitude) How close is the nearest home to the operation (The shortest distance as the "crow flies", not the driving distance)? What are your main concerns?* Permits Industrial livestock facilities generally need permits for stormwater, construction and/or ongoing operation (requirements vary). Knowing which permits have been filed—and what information they include—can help you take action. What are the statuses of any required permits?* (If you're not sure, we'll help you find this later.) Examples of permits that may be required: county permit, conditional use permit, variances, construction permit, stormwater permit, NPDES permit, state CAFO permit. If you have a copy of any permits or permit applications, please share a website link if they're online. Status of Required Permits Application Submitted, No Public Notice Issued Yet Public Notices Issued and Hearing Dates Set Permits Issued Possible Permit Violations (Failure to Obtain or Violation of Existing Permit) None Required Unknown Other Website Link of Permit Additional Info About Permit Status Community Organizing Have you formed a community group? If so, please provide the name, number of members, and website or social media page(s). Please list any other groups or organizations that you're working with or that you've contacted for help. Other steps taken so far How did you hear about SRAP?* Internet Search Media Previous Client Referral from an organization Referral from an individual Social Media Other If other, how? Are you interested in water testing? Learn More Yes No Not Sure I would like to receive SRAP's email newsletter, action alerts, and other updates. As a next step, SRAP's field team will contact you to schedule a video conference call to create an action plan.
