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STORMWATER ANNiJAI; REPORT -SAND AND GRAVEL <br />Permit Cert. No. COG50 4 ~ ~ ~ <br />Second 1'nspection -Date 7 P9 / 9Z Findings, and action taken: <br />Second maior storm event occured. BMPs mere a6ec!uate to maintain <br />control of stormtrater with no discharce off site. <br />Other Inspections -Date -/_/_ Findings, and action taken: <br />C. Results and interpretation of any stormwater monitoring performed. Anach a separate sheet with the lab <br />results. (Monitoring is not a requirement under the permit, unless you were specifically duected to do se <br />b}' the Division. However, the results of any stormwater monitoring that you performed on your own <br />should be repotted here.) <br />Monitoring Results Attached^ ~ No ^ Yes <br />D. Certification <br />"I certify under penalry~ of law that this document and all attachmenu were prepazed under my direction o: <br />supen~ision 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 <br />system. or those persons directly responsible for gathering the information, the information submitted is. <br />to the bes[ of my knowledge and belief, true, accurate, and complete. I am aware that there are <br />significant penalties for submitting false information, including the possibility of fine and imprisonment for <br />Signature of Permittee (legall}lresponsible person) Date Signed <br />Donald L. Opiteir,. Oaeratior.s Manager <br />Name (printed) Title <br />n~~ a.+;,:,,,~t ~,~o. ac ..-eded Paer 2 0~ 2 <br />