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Nutrient Management Plan Report <br /> General Order No. R5-2007-0035,Attachment C <br /> July 1, 2009 deadline <br /> SAMPLING AND ANALYSIS PLAN CERTIFICATION <br /> A. DAIRY FACILITY INFORMATION <br /> Name of dairy or business operating the dairy: Mello Ranch <br /> Physical address of dairy: <br /> 27181 E Carter RD Escalon San Joaquin 95320 <br /> Physical Address Number and Street City County Zip Code <br /> Street and nearest cross street(if no address): <br /> B. DOCUMENTATION OF QUALIFICATIONS AND PLAN DEVELOPMENT <br /> 1 certify that 1 meet the requirements as a certified specialist in developing nutrient management plans as described in Attachment <br /> C of Waste Discharge Requirements General Order No. R5-2007-0035 and that 1 prepared the Sampling and Analysis plan. <br /> Technical Service Provider <br /> TITLE/QUALIFICATIONS OF CERTIFIED NUTRIENT MANAGEMENT SPECIALIST <br /> I/4zlaz �� 7/28/21 <br /> SIGNATURE OF TRAINED PROFESSIONAL DATE <br /> Vince A Furtado <br /> PRINT OR TYPE NAME <br /> 2857 Geer RD;Turlock, CA 95382 <br /> MAILING ADDRESS <br /> (209)250-2471 <br /> PHONE NUMBER <br /> C. OWNER AND/OR OPERATOR CERTIFICATION <br /> /certify under penalty of law that/have personally examined and am familiar with the information submitted in this document and <br /> all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, 1 believe <br /> that the information is true, accurate, and complete. 1 am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment. <br /> Jarred Mello <br /> SIGNATURE OF OWNER OF FACILITY SIGNATURE OF OPERATOR OF FACILITY <br /> Jarred Mello <br /> PRINT OR TYPE NAME PRINT OR TYPE NAME <br /> J u l 28,2021 <br /> DATE DATE <br /> Mello Ranch 127181 E Carter RD I Escalon,CA 95320 1 San Joaquin County I San Joaquin River Basin <br /> 07/19/2021 14:28:48 Page 22 of 26 <br />