Month/Year:

Name of Dairy:

Check Day of the Month the Mitigation Measure is Performed

Daily* Weekly*

No 

Report OR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

FEED CHECKLIST:

1.

2.

3.

4.

5.

6.

7.

SILAGE PILE CHECKLIST:

1.

2.

Maintain records of feed company guaranteed analyses (feed tags), ration sheets, or feed purchase records or other records of 

feed content and formulation that demonstrate compliance with National Research Council (NRC) guidelines.

Maintain records of date of measurement, type of silage pile measured, and average bulk density

Cover all silage piles, except for the area where 

feed is being removed from the pile, within 72 

hours of last delivery of material to the pile.

Maintain records of the thickness and type of cover used to cover each silage pile and records of the date of the last delivery of 

material to each silage pile and the date each pile is covered. Documents from contractor(s) containing this information are 

acceptable.

Check day when feeding of total mixed rations 

begins no later than 2 hrs after of mixing

Check day uneaten feed is removed after rain 

event within 24 hrs (leave blank if no rain)

Moisture content ≥ 45% for total mixed rations that 

contain at least 30% silage by weight

Check day that feed is pushed within 3 feet of 

feedlane fence within 2 hrs of placing feed or feed 

trough is used to keep feed within reach of cows.

Check day when grain is stored in a weatherproof 

structure (October thru May only)

Feeding steam-flaked, dry rolled, cracked or 

ground corn or other steam-flaked, dry rolled, 

cracked or ground cereal grains

MY MEASURES

a. Measurement of average bulk density of silage 

piles (average bulk density of piles must be ≥ 44 

lb/ft3 for corn silage and 40 lb/ft3 ft for other silage 

types)

Maintain records of feed company guaranteed analyses (feed tags), ration sheets, or feed purchase records or other records of 

feed content and formulation that demonstrate that steam-flaked, dry rolled, cracked or ground corn or other steam-flaked, dry 

rolled, cracked or ground cereal grains were fed 

Maintain weekly records of formulation of total mixed rations and added moisture to demonstrate that calculated moisture content 

≥ 45%

c. Minimum ave. moisture content (65% for corn 

and 60% for other crops), maximum Theoretical 

Length of Chop (TLC), and layers ≤ 6 inches.

Maintain records of type of silage pile(s) moisture content of crop, and TLC roller opening settings of harvest equipment for each 

crop. Document(s) from contractor(s) containing this information are acceptable.

b. Use of District-approved spreadsheet used to 

determine average bulk density.

PAGE 1 OF 3 June 2011

Maintain records of type of silage pile(s), moisture content of crop, and copy of inputs entered into the District-approved 

spreadsheet or document from contractor indicating that practices were adjusted per the spreadsheet to achieve the required 

bulk density.

*By Checking daily and/or weekly, I certify that I perform these mitigation measures on either a daily basis (if daily checked) or on a weekly basis (if weekly checked)

OWNER/OPERATOR SIGNATURE 

I have reviewed the above and I certify that the 

recordkeeping for this month is correct

Feed according to National Research Council 

(NRC) guidelines.

The measures that you have chosen will be listed on your Permit to Operate or your 

temporary permit also known as an Authority to Construct. Remember that the 

measures that you have chosen must be followed at all times. If you wish to change 

to a different measure, a permit application must be submitted and approved by 

the Air District. 

Use this form to keep records by checking off 

each day that the mitigation measures are 

performed. NOTE: Not all the measures listed 

below have to be performed. Only keep records 

on the measures that you have chosen. 

Please contact the San Joaquin Valley Air Pollution Control District 

if you have any questions about record keeping. Modesto office209-557-6446, Fresno office-559-230-5888, Bakersfield office-661-

392-5665. Checklist can be found at the following addr: 

www.valleyair.org/busind/comply/compliance_forms.htm

Dairy Compliance Checklist
 Month/Year:

Name of Dairy:

Daily* Weekly*

No 

Report OR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

SILAGE PILE CHECKLIST cont:

3.

4. OR

5.

MILK PARLOR CHECKLIST:

1. OR

OPEN CORRAL CHECKLIST:

1.

2.

OR

OR

3. OR

4. OR

5.

OR

6. OR

7. OR

8. OR

 Month/Year:

Check day that silage piles were visually 

inspected to verify that the working face was 

Silage Additives (Inoculants: homolactic bacteria 

and preservatives: propionic acid, benzoic acid, 

Check when parlor is flushed either before, 

during, or after each milking

Check day pens/corrals are groomed to maintain 

a dry surface (not required during rain)

b. Check day manure was removed from corrals 

(must be at least once between April & July and 

Sept. & Dec)

a. Check day manure was removed from corral 

(must be at least 4 times per year); or

OWNER/OPERATOR SIGNATURE 

I have reviewed the above and I certify that the 

recordkeeping for this month is correct

*By Checking daily and/or weekly, I certify that I perform these mitigation measures on either a daily basis (if daily checked) or on a weekly basis (if weekly checked)

PAGE 2 OF 3 June 2011

For each silage pile maintain records of type of additive and quantity of additive applied.

Check day pipes & water troughs were checked & 

repaired for leaks (must be at least every 7 days)

b. Record depth of manure on concrete lanes at 

highest point every 90 days (must be ≤ 12")

Check day when lime/thymol was applied to the 

pens/corrals

Check day manure cleaned from under corral 

shades (at least every 14 days except when 

weather prevents access to corrals)

a. Check day concrete lanes in corrals are 

scraped, flushed, or vacuumed (must be daily for 

mature cows and at least every 7 days for support 

stock); or

Calculate and record the maximum total exposed area for silage piles; or record date(s) that piles were inspected to verify that 

the total exposed area was less than 2,150 ft2 for a single open silage pile; or less than 4,300 ft2 for multiple open silage piles 

(inspection of piles required at least one per month):

Total exposed area of silage piles less than 2,150 

ft2 for a single open silage pile; or less than 4,300 

ft2 for multiple open silage piles

MY MEASURES

Record depth of manure at highest point at the 

fenceline every 90 days (must be ≤ 12")

Record depth of manure in the corrals at highest 

point every 90 days (must be ≤ 12")
Name of Dairy:

Daily* Weekly*

No 

Report OR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

1.

OR

2.

3.

OR

4. OR

SOLID MANURE CHECKLIST (This Section Only Apples to Large Dairy CAFs with ≥ 1,000 milk cows):

1. OR

OR

2. OR

OR

LIQUID MANURE CHECKLIST:

1.

2.

3.

LAND APPLICATION CHECKLIST:

1.

2.

OR

Test lagoons for pH at least once every calendar quarter, with at least 30 days between tests, and retain records of test.

Check day animals were not allowed in exercise 

pens, corrals, or drylots

MY MEASURES

Maintain records of design specifications and calculations (e.g. Minimum Treatment Volume and Hydraulic Retention Time) 

demonstrating compliance with the requirements of NRCS Field Office Technical Guide Code 359

Check day wet manure was removed from 

freestall beds; or bedding was groomed (must be 

at least every 7 days for large dairies with ≥ 1,000 

milk cows and at least every 14 days for medium 

dairies with 500 - 999 milk cows)

a. Check day manure removed from facility (within 

72 hrs of removal from corrals); or

FREESTALL CHECKLIST:

Anaerobic treatment lagoon 

b. Check day dry separated solid piles are 

covered (from October through May only)

Phototropic lagoon (testing required at least every 

calendar quarter)

Use of non-manure and non-separated solids 

bedding (e.g. rubber mats, almond shells, sand, or 

water beds) for at least 90% of bedding material

Test lagoons for bacteria concentration, bacteriochlorophyll concentration, or other approved parameter at least once every 

calendar quarter, with at least 30 days between tests, and retain records of test.

Check day fields were visually inspected to verify 

that liquid animal waste did not remain in the fields 

for more than 24 hrs after irrigation.

Maintain records of moisture content of solid manure and date applied (records maintained for the Regional Water Quality Board 

are acceptable)

OWNER/OPERATOR SIGNATURE 

I have reviewed the above and I certify that the 

recordkeeping for this month is correct

b. Moisture content of solid manure ≤ 50%

Lagoon pH between 6.5 and 7.5 (testing required 

at least every calendar quarter)

b. Check day dry manure piles outside the pens 

are covered (from October through May)

PAGE 3 OF 3 June 2011

Check day lanes are vacuumed or scraped either 

before, during, or after each milking; or lanes are 

flushed or scraped at least 3 times per day

a. Check day dry separated solids removed from 

facility (within 72 hrs of removal from drying); or

a. Record day solid manure applied and day 

incorporated (must be incorporated within 72 hrs); 

*By Checking daily and/or weekly, I certify that I perform these mitigation measures on either a daily basis (if daily checked) or on a weekly basis (if weekly checked)

Maintain records of type and quantity of bedding material used or purchased

Coaxial/ 2-Point Phase I and Balance Phase II Vapor Recovery Systems Daily Inspection Checklist Protocol