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PART I <br />Page 26 of 47 <br />Permit No.: CO0000213 <br />3) The written authorization is submitted to the Division. <br />b. If an authorization as described in this section is no longer accurate because a different individual or position has <br />responsibility for the overall operation of the facility, a new authorization satisfying the requirements of this section <br />must be submitted to the Division prior to or together with any reports, information, or applications to be signed by an <br />authorized representative. <br />The permittee, or the duly authorized representative shall make and sign the following certification on all such <br />documents: <br />"I certify under penalty of law that this document and all attachments were prepared under my direction or supervision <br />in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information <br />submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly <br />responsible for gathering the 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 information, including the <br />possibility of fine and imprisonment for knowing violations." <br />5. Additional Stormwater -specific requirements (Outfalls 007.008.009.011.012, 016 and 017) <br />a. Annual Report: <br />ICIS Code <br />Description <br />Due date <br />Frequency <br />The permittee shall submit an annual report to the division for the reporting <br />00308 <br />March 1 <br />Annual <br />period January 1 through December 31 <br />L The Annual Report shall include: <br />• Name of permittee, address, phone number <br />• Permit certification number <br />• Facility name and physical address <br />• Contact person name, title, and phone number <br />• Summary of inspection dates <br />• Corrective action documentation as required in the CORRECTIVE ACTON section and status of any outstanding <br />corrective action(s). <br />ii. The signed copy of each annual report shall be submitted to the Division at the address below, and a copy <br />maintained with the SWMP. <br />Attn: Annual Report <br />Colorado Department of Public Health and Environment <br />Water Quality Control Division <br />WQCD-P-62 <br />4300 Cherry Creek Drive South <br />Denver, Colorado 80246-1530 <br />b. SWMP Records: The permittee shall retain copies of the facility SWMP, including any modifications made during the <br />term of this permit, documentation related to corrective actions taken, all reports and certifications required by this <br />permit, monitoring data, and records of all data used to complete the application to be covered by this permit, for a <br />period of at least 3 years from the date that coverage under this permit expires or is terminated. <br />