Laserfiche WebLink
Appendix I - Blue Valley Ranch Site <br />Stormwater Pollution Prevention Plan ( SWPPP) <br />Blue Valley Ranch Site at 3375 Colorado State Highway 9 <br />Delegation of Authority <br />I, (name), hereby designate the person or specifically described position <br />below to be a duly authorized representative for the purpose of overseeing compliance with <br />environmental requirements, including the Construction General Permit, at the <br />construction site. The designee is authorized to sign any <br />reports, stormwater pollution prevention plans and all other documents required by the permit. <br />(name of person or position) <br />(company) <br />(address) <br />(city, state, zip) <br />(phone) <br />By signing this authorization, I confirm that I meet the requirements to make such a designation <br />as set forth in Appendix I of EPA's Construction General Permit (CGP), and that the designee <br />above meets the definition of a "duly authorized representative" as set forth in Appendix I. <br />I certify under penalty of law that this document and all attachments were prepared under my <br />direction or supervision in accordance with a system designed to assure that qualified personnel <br />properly gathered and evaluated the information submitted. Based on my inquiry of the person <br />or persons who manage the system, or those persons directly responsible for gathering the <br />information, the information submitted is, to the best of my knowledge and belief, true, <br />accurate, and complete. I am aware that there are significant penalties for submitting false <br />information, including the possibility of fine and imprisonment for knowing violations. <br />Name: <br />Company: <br />Title: <br />Signature: <br />Date: <br />SWPPP Preparation Date 02/12/2015 Prepared by <br />dkounuan <br />L1 <br />