NOTICE OF INTENT

     NOTICE OF INTENT (NOI) to be Covered by the General Permit
for Concentrated Animal Feeding Operations.  

This notification shallnot be made to EPA, Region 6 if prohibited
from coverage under Part I.C. of this permit.  

Name and Address of Facility (include County or Parish):_________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
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Telephone Number:________________________________________________
_________________________________________________________________
Name of Operator:________________________________________________

Name, Address and Telephone Number of Owner (if different):______
_________________________________________________________________
_________________________________________________________________
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Numbers and Type(s) of animals confined at the facility (e.g.,
feeder pigs, dairy cows, etc.):__________________________________
_________________________________________________________________
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Total acreage occupied by the facility:__________________________

Latitude and Longitude Location of the Facility:
     LATITUDE  _____ degrees  ______ minutes   ______ seconds
     LONGITUDE _____ degress  ______ minutes   ______ seconds

Receiving stream (if known):_____________________________________

State Permit Number (if applicable):_____________________________

Signature:



____________________________________________  ___________________
Signature must be in accordance with          Date Signed
Part IV.I. of the General Permit