Laserfiche WebLink
STORMWATER ANNUAL REPORT - - SAND AND GRAVEL <br />Permit Cert. No. COG-34 <br />Second Inspection - Date LO/LO/ 07 Findings, and action taken: / V(-) SfUkn1\ <br />Other Inspections -Date Findings, and action taken: IVIA-- <br />0o fN?G, p 1. C) Al 'W. A ` fi u.v?ba,+?C?e S ha11-e ?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? 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, and complete. I am aware that there are significant penalties for <br />submitting false information, mcludmg the poss'Fility'-d fine and nprisom ent for knowing violations. " <br />Signature ?f Permittee (legally responsible person) <br />MASC)I-j ?. ellh <br />Name (printed) <br />e v-- D D-evwkY <br />?Li, 0 <br />Date Signed <br />Title <br />Use additional pages as needed. Page 2 of 2 09/07dj