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Pathogen Destruction Certification Statement by Biosolids Preparer <br />°I certify, under penalty of law, that the Table I metals based requirements <br />in section 64.12(A); the appropriate Class A pathogen destruction <br />requirements in sections 64.12(B)(1) through 64.12(5)(7), or the <br />appropriate Class B pathogen destruction requirements in sections <br />64.12(B)(8) and (9); and the appropriate biosolids stability requirements in <br />sections 64.12(C)(3) through 64.12(C)(10). if utilized, have been met. I <br />further certify that the applier has been provided notice of and necessary <br />information to comply with the requirements of the Biosolids Regulation, <br />and specifically with the appropriate.biosolids stability requirements in <br />sections 64.12(C)(11) through (13), if utilized, and the appropriate <br />management practices in sections 64.13, 64.15, and 64.16. This <br />determination has been made under my direction and supervision in <br />accordance with the system designed to ensure that qualified personnel <br />properly gather and evaluate the information used to determine that the <br />pathogen requirements have been met. I am aware that there are <br />significant penalties forfalse certification including the possibility of fine <br />and imprisonment." <br />Signature: <br />WI um Wastewater Operator <br />PO Box 130 <br />Gypsum, CO 81637 <br />Date: ,r}/"- -3/ r 0