Laserfiche WebLink
STORMV~ATER ANNUAL REPORT -COAL <br />- Permit cert. No. COG850 _ _ <br />Second Inspection -Date 11/1~/2Z• Findings, and action taken: <br />Inspections show compliance with the plan Partial incppfr;nn ro ry=.:f~„~a~ <br />Deficiencies are documented and tvnical lv corrected within nna mnnrh of f; nA;,,g <br />Other Inspections -Date _„/_/_ Findings, and action taken: <br />C. Results and interpretation of any stormwater monitoring performed Attach a separate sheet with the Iab <br />results. (Monitoring is oot a requirement under the stormwater section of the permit, unless you were <br />specifically directed to do so by the Division. However, the results of any stormwater monitoring thaz <br />you performed on your own should be reported here. Any monitoring you performed under the process <br />water section of the permit is reported separately, on DMR forms, and should not be included here.) <br />Monitoring Results Attached? ®No ^ Yes <br />D. Certification <br />"I certify under penalty of law that this document and all attachments were prepazed under my direction or <br />supervision 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 best of my knowledge and belief, true, accurate, and complete. I am aware thaz there aze <br />significant penalties for submitting false information, including the possibility of fine and imprisonment for <br />knowing violations.' _ <br />Signature of Permittee (legally responsible person) Date Signed <br />MIC~~IEI N. G~bS~ Manager, HSEQ and Land <br />Name (printed} <br />Title <br />Ux additional pages as needed. Page 2 of 2 ~t11194ct <br />