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Nutrient Management Plan Report General Order No. R5-2007-0035,Attachment C July 1, 2009 deadline STATEMENTS OF COMPLETION Waste Discharge Requirements General Order No. R5-2007-0035 for Existing Milk Cow Dairies (General Order) requires owners and operators of existing milk cow dairies (Dischargers) to develop and implement a Nutrient Management Plan for their land application areas (land under control of the Discharger, whether it is owned, rented, or leased, to which manure or process wastewater from the production area is or may be applied for nutrient cycling). The Discharger is required to maintain the NMP at the dairy, make the NMP available to Central Valley Water Board staff during their inspections, and submit the NMP to the Executive Officer upon request. The General Order requires the Discharger to submit two Statements of Completion during development of the NMP. The Discharger may use this form to comply with the General Order requirement to submit one or both of these Statements of Completion. Parts A and E must be completed for each Statement of Completion. Parts B, C and D are to be completed for the Statements of Completion due by 1 July 2008, 31 December 2008 and 1 July 2009, respectively. Both the owner and the operator of the dairy must sign this form in Part E below. A. DAIRY FACILITY INFORMATION Name of dairy or business operating the dairy: Mello Ranch 27181 E Carter RD Escalon San Joaquin 95320 Number and Street City County Zip Code Street and nearest cross street(if no address): Operator name: Telephone no.: Landline Cellular Mailing Address Number and Street City State Zip Code Legal owner name: Mello,Jarred Telephone no.: (209)573-3748 Landline Cellular P.O. Box 22 Escalon CA 95320 Mailing Address Number and Street City State Zip Code Mello Ranch 127181 E Carter RD I Escalon,CA 95320 1 San Joaquin County I San Joaquin River Basin 07/19/2021 14:28:48 Page 24 of 26