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38. Stormwater Mttwsement Plan: This item applies to all renewal permit applicants where the facility has atormwater coverage through a <br />combined process water/Stormwater permit (individual or general) or through separate process water and Stormwater permits (and [nay apply <br />to other facilities). In these cases, the permittee shall sign the following eenification sutement. if a SWMP has not been prepared, see the <br />SWMP guidance document in Appendix C-2. <br />'1 eenify order penalty of law Nat a complete Stormwater Mamgement Plan, in eonforrmnce with Appendix C•2 of Nu application, has been prtparrA for my <br />facility. Based on my inquiry of Ne person or persom who tmmge Nc rystem, or Nose persons dirtcdy rtspomiblefor gathering Ne infonmrion, Ne SWMP <br />it, to the heu o[ my kmwledge and belie[, tme, acwtate aM compkte. 1 am aware Nat Nere art sigsufeart pemlries for faluly cenitying the wmpluettess of <br />aid SWMP, including Ne possbBiry of fine atd imprisonment.' <br />Sigmmre of Permit Applir~m Date Sighed <br />Name (printed) Tide <br />39. SSertature of Applicant <br />'1 certify under pemlry of Isw that Nis dowmem and all attuhmenu were prepared under my direedon or supervision M aturdartce wiN ^ syrtcm designed m <br />assort tlut qualified persomtel pmpedy gathered and evduated dte infomufion subtrtitted. Based on my inquiry of Ne person or persons who mamge Ne <br />system, or thou penom direcdy rtspomible fos gathering Ne infortmtion, tM irdomution subtaitu4 is m Ne 6est of my ~owledge atd belief, we, acwote <br />atd eomplem. Ism await flue Nert art sigoifieant pemltia for submitting false infomution. including Ne possibdiry of lure atd imprisonment for knowing <br />viohdom.' <br />Sigtuturt of Owrcr <br />Name (printed) <br />Sigmmrt of Operator <br />Name (printed) <br />Date Sigued <br />Tide <br />Dau Sigrtcd <br />Tide <br />Cod Mining App. ~19a <br />