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STORMWATER ANNUAL REPORT - - SAND AND GRAVEL <br /> Perthit Cert.No. COR34/COG-50 1646 <br /> Second Inspection-Date 6J�o�. Findings, and action takers: <br /> No action necessary. <br /> Other Inspections -Date 1 14/ 01 b <br /> 9 , Findings, and action taken: <br /> No action necessary. <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? Fv� No Oyes <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 wida a.system designed to assure ifiat 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 Elie Luc,accurate,and complete. Lain aware4W&ere are sigma penalties for <br /> submitting false information, including the possibility of fine and imprisonment for knowing violations." <br /> 2/10/2017 <br /> Signature of Pcrmittee(legally responsible person) late Signed <br /> Thomas E . Brubaker— Pyt;-n1- <br /> ident <br /> Name(print&d) Title <br /> Use additional pages m needed. Page 2 of 2 ar l i>>sg <br />