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STORMWATER ANNUAL REPORT - - SAND AND GRAVEL <br />Permit Cert. No. COG-34 <br />Second Inspection - Date A /0/ 07 Findings, and action taken: <br />k <br />ND S k kk l a ?e G+ <br />e?rlInspft\ K'0 ections - ?p Date Findings, and action taken: <br />r <br />e <br /> <br />C. Results and interpretation of any stormwater monitoring performed. Attach a separate sheet with the lab <br />results. (Monitoring is not a requirement under the permit, unless you were specifically directed to do so by <br />the Division. However, the results of any stormwater monitoring that you performed on your own should be <br />reported here.) <br />Monitoring Results Attached? -D?-No Yes <br />D. Certification <br />"I certify under penalty of law that this document and all attachments were prepared 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 system, <br />or those persons directly responsible for gathering the information, the information submitted is, to the best <br />of ?my knowledge-and-=belief,-->true,= accurate-atecomplete., am aware that there are significant penalties for <br />submitting false information, including the possibility of fine and imprisonment for'know g viofati?ns- "-? - <br /> <br />Signature of J?ermittee (legally responsible person) <br />?' k? o-k A - <br />Name (printed) <br />TTeP ndrlitinnal nnaac ac nPPAPrI <br />t" Kcw <br />f,/' p J <br />Date Signed <br />ral,L*.- <br />Title <br />Pa aP 7 of 7. <br />n9/n7t1i