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COLORADO DEPARTMENT OF HEALTH <br />Water Quality Control Division <br />WQCD-PE-B2 <br />4300 Cherry Creek Drive South <br />Denver, CO 80222-1530 <br />SAND AND GRAVEL MINING AND PROCESSING <br />GENERAL PERMTT <br />CERTIFICATION OF COMPLETION AND IMPLEMENTATION OF <br />STORMWATER MANAGEMENT PLAN <br />Permittee Facility Number: COG - 5 0 0 8 0 8 <br />Company/Permittee Name: John 0. Buckner <br />Facility Name: <br />CRYSTALJACK <br />"I certify under penalty of law that a complete Stormwater Management Plan, in <br />compliance with Part I.C.2 of the Sand and Gravel Mining and Processing general <br />permit, has been prepazed and implemented for my facility. Based on my inquiry <br />of the person or persons who manage the system, or those persons directly <br />responsible for gathering the information, the Stormwater Management Plan is, to <br />the best of my knowledge and belief, true, accurate, and complete, and <br />implemented as written. I am awaze that there aze significant penalties for falsely <br />certifying the completion and implementation of said SWMP, including the <br />possibility of fine and imprisonment for knowing violations." <br />Signature of Applicant Date Signed <br />John 0. Buckner Owner <br />Name (printed) Title <br />