960121_Other_20200310

'FuRM IRS
FWd Sao (wetted =69) = (A)
Farm Owner
Owner's Address
Owners Phone #
Lagoon Liquid Irrigatip.. . Jds Record
One Form for Each
7-m,w Zone #1 7
Y.0 ft ve- Afr
af
In -
Field per Crop Cycle _1'0
Facility Number
I LIZ
Irrigation operator A A- '7CA c k, noa %
Irrigation Operator'se0aA ,, 2-
'�
Address • 101/1ve-
Operator's Phone #6L-
09,
From Waste utuladon Plan
Crop Type Recocnmeodod PAN
Loading wam)l
(21 (a) (41 i-sn (M M
IM
I
-
in
is
MRWM
IIIIIPIPI M19170M.
MM" M.-
NORM
0~9 sigmftre
C9rWed0peraWQ" Vj'jj;-AA-L ... L77-oi&&V Operator's Ceralcdon No. AWA
NCDA Waste Ana*is br EquiValent. At a minimum, waste analysis is required within 60 days of land application events.
Enter the valuie received by subtracting column (10) from ft Continue subbmIng column (10) from column (11) f6flowing, each
'**EntermMent source 0e. Lagoon/Storage Pond 10, commerical fertilizer, dry liter, etc.)
irrigstioh event.
1212M006

fu.*M IRr.2 Lagoon Liquid irrigatk? ..:" Record ,r
Field sirs t aid acres) =
Farm Owl
Ownees Phan
One Forte for Esch Field per Crop Cycle
Facility Number
i aaon -
in 7s6 cd u .� C
Address uc — C. cZ 9s
opw*oes Ph "M # ' I 1 L -
F"M VftdR UMbgdM Plan jg!6j9_.- S coo . aG .13z/q,41 j 9 .
• Rsoararretrdad PAN
ri n::...•4.•.a.... ».:.s..s...•au. c: »..... .a.ra_. •. _. r..:..•.er...:.ws.saa.-lx..�:.......•c..-..c. r...L.u. .u.:......-:. a.: .. i. ...:.:..:•:,a .... .� ..: _. ...... :.a..a•.r::».:....- .�^. •:»- . �..''�"�..a+...+..-....`_...'--....
ww��v�■eat.��a�av�■�w.�c,.�.�.���.�......��x�..,...�._.�...
111aw"IMPAMIR
oil
-
E
—MEMO
r/
�1 III
or
I • '
II�I�
�'�
��
�* �OEi
w
e�l�r����lr�l��l�
!�■�l��lala
xlwrtm% �gnetirns Open "s
Ops dor p'" Oft W U1 10
* IdCDA Was* Anaylsis br Equivalent. At a mom, %M%e anailysis is aequi W W" W of land application events.
Enter v r C&W by subtra ft cd nn (10) fmtr W Continue s ftad g C*mn (10) from column (11) fogowing each irrigation evoent.
`**Enter=Went source Qe. LagoonfStorage Pond ID, commerical ferhAm dry rdet, etc-) 1212012006

fuRM lk 2
Find Size (washed ems) = (Aj
FWMOWM
OM raft Address 17X
Ow pees Phase #
Lagoon Liquid Iffigabc.0..:" RecoW
One Form far Each Field per Crop Cycle
« mmm
.� -
�� .1 " e
- '
Ffm waste UWmAm Plan 9 --Age
Cmp t (�
Type mmumnda51
ra l Xi i�re)
• a.t L.. •. _.LJ.:..•.IY..At3C�=•s...Y..�.........x.....�C. !•w �S Je. .Y.Y.. ..-1. a.i -. i. ...S.S..r•:.1 .... �. -` .i.. :J--i3•.�.. Cam.:...... .::..n r-_ _ _ _ .,...��......
-- ,.. ..� ,�. n► rm � .._ rci Het ti i)
M i "
r�r��r�r�r����e
�■��r�r�
t"i FI Osritllaaion Na
* MCDA Was% Anwkb br Equivalent. At a minimm, waste analysis ld mWkW min 6D days of land application "nis.
`* EriWfe vale rewNed by st tjadng edwnn (10) f m (ft Codnue subt wft c*mn (10) from column (11) *Aom+ing each
Irrigation event
121=006
%**Er wm&jw t source (le. Lagoons torage Pond ID, commerical far IiW, dry Cat, etc.)

• PURM If r 2
Lagoon Liquid Irrigatip... Ads Record
One Fora for Each Field per Crop Cycle
Facility Number Field Size size (wetted acres) = (A)
Farm Owner i Irrigation Operator 4cto
Owner's Address X
C u a u irrigation Operator's 7 S6 u K C fv-• .
OEvc l Address f .
Owner's Phone # Ci Z. • Operator's Phone #
From YYasis utilisation Plan -.2019
Crop TWO Recommended PAN ,�+C
Loading Ofac re)
(1) (2) (a) (4) (S) a m (81 LL (9) (10) (11)
1IIoHMMMM,77TM1MN
., a :. �'1 1 III:
n
.
1IffM1111771�1_
I
III1'�
R IN
®■■��
�■�
�
�
�
��
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��o
�■�
err
■�
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sill
i�i
�■��w��■���ii�
-
.,.
ram■
.■�.■
Owwnees signature C 's Aina"e
Ceffed Operator iPn Operator's Certiftidion No.
" NCDA Waste Anaylsis br Equivalent. At a m-Thirnum, waste analysis is required with 60 days of land application eve
to iats.
Enter e value received by subtracting column (10) from {B). Continue subtracting column (10) from column (11) following each irrigation event.
'"EnteriuMerd source (ie. Lagoon/Storage Pond Ib, commerical fertilizer, dry Nttef, etc.) 12120/2006

AJRM lk 2
FW sw (weaed ) = (A)
Farm Owner
Owners address
Owners Phone #
Am .M
Lagoon Liquid Irrigabc,,.. Ads Record
One Form for Each Field per Crop Cycle
Ll�63 zone #
�IIIWVG
F,, e ri AM-7
�1/RNII.,
, UWAIN - 04'
' r '� -'
wai
WAIM
Fuse Womb upon Plan1 P9,019Crop 1VI)e
�► R _j
Loah9 Waeme) rr
.4n u. nn - an M lm " m (IM (11)
) t'
moil
r i
•
r
J
o`IR:Z.
W
C~pperabor(Prirrq opejr,+� ft tlon W.
* NCDA VVMft Aroylsis br Equivalent. Ai a m t>Fium, wane analysis iod w 6A days of land mpplicatlon events.
"* Enter the reeiyed by subtracting c umn (10) front W Camtinue m� column (14) from column (11) fiollowing each irtlgatEon evert.
'**Erkr mublent source Qe. Lagoon/Storage Pond ID, commerical fef$kpr, dry 1W, etc.) . 12120t2006

fuRM lkr 2 = Lagoon Liquid Irrigallco,..:" Record �
One Forth for Each Field per Crop Cycle
1- 4.) 3 zoee #
Faulty lumber
Fled sks ONSftd
wm
trrkow Operator
+i
CWnwft Address
% u
G u lnigdQn OperSWS
C V J•
,
. 0 I've,
A Addnass
f•07 1, llt
Ownees Phcme #
1
operwft Phone #
L 2_- 6
From wadnnPbn
12�r3/ �0 a
• CMType
^^ PJK=unentkd PAN
�
.
s U I /dt AiLo�tg
(p�lacxe)
�
L:-..r�.YLL.- •.
�.. .....-..,_yi,--.:......
b.. ....t. !•.. �s .Y. .Y.1...-ati Lt -. t. ....s- �..
y •� ;.L-A•.L�:...:... •.. •. •l..-- - w..•+.�..-..-��+r..--�...
.......�� .Y.d.I.t4�tr s.
•...:. Lt J..: A.•1..-.L.•.}...w:.tS..s-ltA
.41k ,,,a An
M rm "
ire► Net Mil
it
I�♦'
11
'1:
W
MIN 11
�
�Y+�
■
�t�R�i01Af1�
11 rim
�,
- , ., -
ram■
��
owaft
sC
* NCDA W69W AnftUis br Equritabnt At a m , wade analysis is requW rt+ Wn W dot's of land applicaftIn events.
'* Enter the helm real MW by subtracting column (10) frotn W Conlinue sWftx*V column (10) from column (11) following each irrigation event.
'**Enivrab d source (le. Lagoon/Storage Pond 10, commedcal fefl ', dry Chet, etc.) 1212012.006

FvRM Ifs 2
Field Size (wetted acres)
Farm owr
owners Addm
owner's Phone
Lagoon Liquid Irrigatic,... Ads Record
One Form for Each Field per Crop Cycle
Zone #
jA) .53
or I'
754 0, - 7
FadI y Number
From Waste utilization Plan - Vol r,3 -o?d/•9
Crop Type a
Recommended PAN14-1S g i o Loading Wacre) 50)
M (3) (41 (S1 (s1 rn (81- 101 11M Mil
INS
%
Qwr►er's Sign2ture Apes �
certified Operator (P" i Operstors won No.
* NCDA Waste Anayisis br Equivalent. At a minimum, waste analysis is required WAIn 60 days of land application events.
Enter the vrallie received by subtracting column (10) from (B). Continue subbwIng column (10) from column (11) following each
'Erdernutrient source (ie. Lagoon/Storage Pond ID, commedcai ferfaizer, dry litter, etc.) .
irrigation event
12/20/2006

FORM lks-2 Lagoon Liquid Iffigatc.st. -Ads Record
One Form for E. ch Field per Crop Cycle
MUM n,
CIO,'
dftdlm Pbn .1 'e)6 I q -
FmmW"R U
CMPTwe ROMINIM 14d PAN
Loa" dbb=)
M m Im
"I,
1 11
3
oil
Wp ME= WIN M#
U M,
Wkj M,
RAM
�Wzm-=;Ym
NCDA VV899 An%isis br Equivalent. At 9 waste wWyWq W m*kW WMn W days of land applekthn V(er*s-
Efiler to wItie rewhied by subiiadng column (10) fmtp Confine 9W*adft cWumn (10) from column (11) folovAnq each IffignWh event.
'**ErdL-riu*W source Qe. Lagoon/Storage Pond lb, commerical feffltm dry MW, de) 1212012006

FURM IR�'2Lagoon Liquid Irrigalp, .Ads Recotd
One Form for Each Field per Crop Cyole
/ 14)0 za►e # FadU y Number
FW Shm (vied acres) _ (A)
ftrm Owner r 44A Z&Ue-, b8atbn openaw ` i
Owner s Address b v h hrtarwn Opmebes / o u r e-;.-.
Owner's Ph" # • 1 L • 6 opffi*Ges KWM #
t
Fnxn 1a01�'
Rawm mended PAN
Type d S 9 i ra Loa" Qb hm)
�, :..: r:,•_...-.:...._..�...��-...>:_..�..z�_. •....:. -•_�..__:......-....,._...,.:.�.•..,....�.L, .......sue.:-:.. - ...._ �..,: _ _ •__.:. __. _...
.. �.,. .a. m nn �a► rn �"' [91s :� A• (10) .•_ •(11�___
I,
�r �. 1
* WDA Wade Aro is br Equtvalerrt• At a mh n, w►aote andysis b d ve" 60 days of land aMcatlon mtents.
EnWto value received by subtracting column (10) from . Continue abbedit e*mn (10) from column (11) following each Irrigation event.
'**EnternubW source (le. LagoonlStorage Pond ID, commerical ferti bmr, dry Bile, etc.) 1=012006
�r �. 1
* WDA Wade Aro is br Equtvalerrt• At a mh n, w►aote andysis b d ve" 60 days of land aMcatlon mtents.
EnWto value received by subtracting column (10) from . Continue abbedit e*mn (10) from column (11) following each Irrigation event.
'**EnternubW source (le. LagoonlStorage Pond ID, commerical ferti bmr, dry Bile, etc.) 1=012006

FURM lid 2
Fled Size (wetted acres) _
Farm
Owner's
Owner's P
Lagoon Liquid Irrigatic,...:ds Record
One Form for Each Field per Crop Cycle
Facifity Number
rrrfgation Operator RU/4A, Z Ckidw
hrigaUan Operator's % vvJuAb. Pa
Address / vc C
Operator's PMne# 91/�.F 02--2--'?CE61
FrornwaeW umftdorr fbn cfC4 ag /9
Crop Type � Recommended PAN
S' (j J .OV 9 (19acre) r z
(11 121 (81 [Al IM IM (Tr (a? 101 1101 (111
Zone
(A)• 73
Icy,
:.:
�.
.:
r�
•
Moo
It '
wq
ciVRWS Signature _ Oaera s sigma----
Cerurred operator (Prirry aytf Operator's Can No. p
* NCDA Waste Anaylsis br Equivalent. At e miRmum, waste analysis is reedited YMln 60 days of land application events.
'* Enter the 1ralt*e revived by subtracting column (10) from (B). Continue subtracting cOumn (10) from column (11) following each irrigation event
' " EntervArlent source (le. Lagoon/Storage Pond ID, commerical fertilizer, dry litter, etc.) 12/20/2006

fuRM IRr x Lagoon Liquid irrigabc,,.Record
One Form kv Eoch Meld per Crop Cycle
7.one # Faculty NurrAW
f%M Skm (Mreaed acres) _ (A) -73
FMM owner 1 "aon OpwaW ,, 4
owner's Address �, qunh 610 I fro ion Opw*bes U r1 e, I Lb
r t Address r'
owner's Phase # LL Opers&ot's Plane #
Pram Waedte Umim[Alon Pion dSed A0 U i 9 '
Crap Type Reow`nftd PAN I
....\. YJ :..: iM'1.3^-4-.J. ... .. :.ts+i-..'J6 t:.. r.�.1.sY.. '...LJ.:..• 1 .-..-�.....J.-..:.....-.•i.. .-..t. J•w�t .R•/J.Y..-.'.. J.t .. i. ...:.:..t•:.3 .' Y ti. .i.•J. w... :.1.8'.Y�.--:...^ .•J..---.+�.riw�-.-ern.--.......
;.j Pn Wk rm wan T IB) " _ fAl Hhl N 11
. I
Bill
0*3 Wi r `
wn= i A
MAN
WN • oowl
sIVAae
cer�lied operaloriPrir� ; operators oar on NM Ak,1A asp..
* NCDA Vft&% Anaylsis br Equivalent At a mfirmifn, w►aoe analysis id required redlbin 60 dens of land application dents.
'* Enter to received by 9WAvac Ling c dumn (10) ftom W Coniinue s*ftc** colurnn (10) from column (11) following each irrWwn event
'**Errb r-nWW source (ie. Lagoon/Storage Pond ID, commerical ferl bw, dry 1W etc.) 92124MON

FORM lid 2 lagoon Liquid Irrigabcow..Ads Record
One Form for Each Field per Crop Cycle
# ; Fedll y Nub
FlMd size fwefed acrft) = (A) , !�
Fenn Owner ��9 r O
Owners Address LS6 v uRk e- lob tell hftadon operam, S 6 , O u A vb
Adder 'je Al
Owners Phone 41 - 2 - Opetater's Phase # LA AL
FMM Wome upon Man AV 1.2017
Cmp Type 0/ "/ Rearm ndad PAN
6J Loaft 4AM)
i.J1.1-.4.•.}•.. .. :.tef?....•iR L:-..r:•. YVL... •...l J. l..• - ....-�..�i.-.........•c..-..C. l•w �i X. .Y.Y...il. Yx i. w 5.:.-: -` .1.. - L•...:. - .:: .... .�.a...�..w....��..—......
MIA n► nn � � rrn� Mel (11)
it
r
QW*ft signore
` 1
(pdnQ operators Oer)�ion
* N ,DA W8f8 Armylsis br Eq&alent At a mWmum, wade anelpis ft wond v Wn W dogs of land application dents.
Enter to v0w received by subtracting column (10) frog W Continue subtr dit column (10) from column (11) foilovAng each inigation event
nt source (ie. I.AgoonlStorage Pond ID, cornmeriml fe1614', dry Inlet, etc.) 1=012006
QW*ft signore
` 1
(pdnQ operators Oer)�ion
* N ,DA W8f8 Armylsis br Eq&alent At a mWmum, wade anelpis ft wond v Wn W dogs of land application dents.
Enter to v0w received by subtracting column (10) frog W Continue subtr dit column (10) from column (11) foilovAng each inigation event
nt source (ie. I.AgoonlStorage Pond ID, cornmeriml fe1614', dry Inlet, etc.) 1=012006

FuRIM its
FM Sim (wetted acres) = (A)
Farm Owner
owners Addrew
Owner's Phone #
Lagoon Liquid Irrigagco,. . Ads Record
S
One Form for Each Field per Crop Cycle
Zone # I
Fadifty Number
Mption operator UdZ Irrigation operators IPA Ulf 6 two
Address ellvc , —
Operator's Phone # :Z 0,6
From Wisaft Uffibmam Wan
Crop Type rAmOr-el-have", -30 Recommended PAN f
... ..... .... .
(1) (21 (3) (4) (M (61 M (8V (a) 1101 (111
WWMATIII
F®RMINIMMIM
vim1 .1 1
RMI V MW M-M
M
130M
��011111
�W
nsmnwlffl��
WUM
now 'In
RMS
IM"M
M.
off=
OK-1=
OEM
��WFMM��
137
QWWs Sinnature pees
'a", Operator's CeMoMon No.
CWMed Opend"011dnQ
NCDA WM% Aneylsis br Eqtilvilehf At aiiilnlrnum, waste analysis is requimd whin 60
Enter the value received by subtracUng column (10) from (B). Continue subtracling colun
'Entermtrient source (ie. Lagoon/Storage Pond ID, commerical fertilizer, dry liftet, etc.) .
9.Af
daysland application events.
n (10) from column (11) f O'llovAng each irrigation event
12/20/2006

FuRM ll Z Lagoon Liquid irrigabc,,.. Ads Record
One Form for Eoch Field per Crop Cycle
Facility Number
Pled Size (wafted acres) = (A) •o,r AV A.
Farm Owner
8 ....
owe's address C o e rn G u 1�9 n s -o u n
L Address s
Owner's Phone # Operamw's Phone # i
iFMM WeNtR U89zedac Plan
CM Type /AVS F-s• Reowwne Wqd PAN
(bland) `
..i L:Le_.a.•.a ... ... :.+ai_.ns c: _.,..:.i,.__. •.-. �:.:..• >. ......a-.y..�:......-x..... s.e-..'i .u•. ..+.a...... a. a.l .. I. ...:.W.: •:... .... .._ v ..: �. ...... :.a._a•.,., e_.:. _-.. - �w •.ara....a.-r. a.:.L_.-...-_..._..
N. an rA m1'" _ rrr f4d1 (11)
✓.1 •�
1 1 1 �-
1 1 1
..
ol
slur
i',e~0pera)or(Pr11M, _ DPKfbft W
* NCDA 1Nsfi9 Ar>aylsis br Equivalent. At a Mbiftun, MOO analysis is PsWk ed min 6D days of larid application events.
'* EnW en rre kn weaved by subtracting column (10) from W Conlinue s*column (10) from column (11) foUowing each Irrigation event.
'**EnhvvWftd sound (le. Lagoon/Storage Pond it), commerical ferbIbm dry li tet, etc.) . 1=012006

fuRM 11 2 Lagoon Liquid Irrigallt, ..:ids Record r
One Form for E;cd Field per Crap Cycle
. RM Sin (weed ) _ (N
Farah Owner
ownsrn Addrm
Owners phone #
W -,..EdI i i
MY�
IIiIL�i —
"' """ "Z 'PA
ikon opwnatw r , c d w
1 s n e
s 1e adder
operator's phone a
c�ropType r�us c���N PAN
n1 1% Iffil al AM fen rn
1 1 1 �
i l l
.,
Y.1
• r
�
all
wo-RAMb
�r
��
�■■�
�■■o
�
�
wars
r�
��
��
�■�■�
�
�■
cL._:... a ��..
C adrOwdar(pdm ,I a ape dQft wowdim W.
* NCDA WssW Anayhds br Equivalent. At a mTnirtiucn, wads mays Id re fined Win W days of kind application "ntss.
Enterfe Value recelmW by subtacting column (10) from W Confinue sdtradbV column (10) from column (11) following each irrigation evert.
'12I20/2.006
'**Enfer�nul�lent source (ie. LagooNfefti�
Storage Pond lb, commedc�l r, dry lifter, etc.) .