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<br /> / .y y •LAN(SWMP)CERTIFICATION-required ONLY for applications requesting
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<br /> ,; o 1•. "a••ement Plan must be coin••leted••nor to si•nin•the followin•certifications!
<br /> - S "'' prior to applying for stormwater coverage under the
<br /> ' � �' �`='` shall be Prepared
<br /> . alIPPI,�Ptan(SW1AP)
<br /> 1Ni d the following certification signed. prepared for my activity.Based
<br /> -: � � ;a rs'- ble for gathering the
<br /> y • n pens of la4r pens a complete age th as s Mango a those Plan persons directly rest
<br /> -- a u_; S. oIJr 1att ur persons Who lan'is to the systemof, knowedge and belief,true,accurate,a i�tuding
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<br /> ,', '4,, ,,„,-o teher age ment Plan is,nthe best al my
<br /> �-� �, - e , .� rtt,ai!there are signifipnt penalties for falsely certifying the completion of said SW►�hP•
<br /> and m}prison eat for.know,ing violations.", .,• x 2
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<br /> .� ri natdre ofilegalytes onsiblePerson or Authorized Agent Date Signed
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<br /> Title
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<br /> ll QUI s•CEaRTIF CATiO S GNATURE[REG 61.4(1)(H)J
<br /> R �r na`*of la that thi:s document and all attachments were preParatd under my her and evalu eUthe informon or s ton n
<br /> ' i y inquit fof he p rassure that r oqualified who panage tl prose ly g
<br /> ?,� ,w•HI�� ��T� Y�gm�"vo( �a person or persons who manage the system,or those persons directly responsible
<br /> :ais to the
<br /> e ng t1 aw sirs at there are significan penalt submitted for submitting false information,mation,ledge rd belief,true,including the possibility ty of te d
<br /> i i�n ant Knowing violations.-. •
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<br /> `' s,v +,frrzs ti4.1 "` Date Signed
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<br /> ' a�;r dtt,m, s ib ,the er�m�ittee,to be}considered complete. Per Regulation 61,in all cases,it shall be
<br /> 15 i r :-. ,- „.a responsible corporate officer. For the purposes of this section,the responsible
<br /> 1 tl c r '- onsibie ffor the overall;operation of the facility from which the discharge described in the
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<br /> r'a a"' -' it f-- , I te,or other public"facility,by either a principal executive officer or ranking elected
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<br /> E a�zr tLi , CO�i.F TH, ORMWATER MANAGEMENT PLAN with the application
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<br /> i i�a t, Qp fr yOE It L BE SENT AFTER THE CERTIFICATION IS ISSUED.
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