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NPDES General Permit for Storm water Dischazges <br />Annual Site Compliance Evaluation <br />Page 3 <br /> <br />Certification by Environmental Supervisor: <br />"I certify under penalty of law that this document and all attachments were prepared under <br />my direction or supervision in accordance with a system designed to assure that qualified <br />personnel properly gather and evaluate the information submitted. Based on my inquiry of <br />the person or persons who manage the system or those persons d'aectly responsible for <br />gathering the information, the information submitted is, to the best of my knowledge and <br />belief, true, accurate and complete. I am awaze that there are significant penalties for <br />submitting false information, including the possibility of fine and imprisonmerit for - <br />knowing violations." <br />Signature: <br />Title: Environmental Supervisor <br />Date: Z <br /> <br />