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S`TORMWATER ANNUAL REPORT- -SAND AND GRAVEL <br /> Permit Cert.No.COR34/COG-50 1528 <br /> Second Inspection-Date 192915 Findings,and action taken: <br /> We had a fairly wet spring and summer but had a very dry winter. There was very little sub soil <br /> moisture. The ground absorbed the rain very quicidy. This fall has been dry and warm. There is no <br /> standing water and our catch basin is dry. <br /> Other Inspections-Date / / Findings,and action taken: <br /> C. Results and interpretation of any stormwater monitoring performed. Attach a separate sheet with the lab <br /> results. (Monitoring is not a requirement under the permit,unless you were specifically directed to do so by <br /> the Division. However,the results of any stormwater monitoring that you performed on your own should be <br /> reported here.) <br /> Monitoring Results Attached? No ZYes <br /> D. Certification <br /> "I certify under penalty of law that this document and all attachments were prepared under my direction or <br /> supervision in accordance with a system designed to assure that qualified personnel properly gather and <br /> evaluate the information submitted. Based on my inquiry of the person or persons who manage the system,or <br /> those persons directly responsible for gathering the information,the information submitted is,to the best of my <br /> knowledge and belief,true,accurate,and complete. I am aware that there arc significant penalties for <br /> submitting false information,including the possibility of fine and imprisonment for knowing violations." <br /> Signature of Permittee(legally responsible person) Dane Signed <br /> Rick Domson Secretary/Tres. <br /> Name(printed) Title <br /> Use additional pages as needed. Page 2 of 2 arin t sg <br />