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~~: <br />STORMWATEIt ANNiJAL REPORT - METAY/ 11~iING (& CoAL).,"~ ~ :~ ~~ ~" ~", <br />Permit Cert. No. COR-040 _ _ _ ~ -" ~ - - . . <br />C. <br />D. <br />_. <br />$CG;1'1.lLSpGCt10n ~ iJ•.t0......!... /. ~ ~Futding:, ,yrd :uxion taken: ~ ~ ~__ =- _. <br /> <br />Other Inspections -Date _/ / Findings, and action taken: <br />Results and interpretation of airy stormwater monitoring performed. Attach a separate sheer with the lab <br />resulu. (Monitoring is not a requiretneni under the permit, unless you were specifically directed to do so <br />by the Division. However, the results of any stormwater monitoring that you performed on your own <br />should be reported here.) _ ~1' uIZF~~ W~~~ MDU ~`roe~-1G-. <br />Monitoring Results Attached? ^ No ~y~ 5r~-r~o~1i IN RED VJA5~1 AFL <br />Scu.t_uoN vurrt~ SAMQI.ED• <br />Certification ~~'~ ~~ ~oZS ~7EOtMENr <br />'PoNo EFF~uEt•rr etc,-~ ha~n~s <br />'I certify under penalty of law that this document and all attaditneats were prepared under my d'uection err <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 informadon, the information submitted is, <br />to the best of my knowledge and belief, true, accurate, and compleoe. I am aware that there are <br />significant penalties for submitting false information, including the possibility of fine and imprisonment for <br />knowing violatJ'gns.' .-- --- _-• = --_ _ - - <br />Signature of <br />Name (printed) <br />(legally responsible person) <br />Date Signed <br />Title <br />Use additional pages as meded. Page 2 of 2 utlNamin <br />