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STORMWATER ANNUAL REPORT — SAND AND GRAVEL <br />Permit Cert. No. COR-34 0943 <br />Second Inspection — Date: OCT 28 2011 Findings, and action taken: <br />Produced 1 foot to 3 foot Rip Rap. 1000 tons. No changes to SWMP plan good. <br />Other Inspections — Date: Findings, and action taken- <br />C. Results and interpretation of any stormwater monitoring performed Attach a separate sheet with the lab results. <br />(Monitoring is not a requirement under the permit, unless you were specifically directed to do so by the Division. <br />However, the results of any stormwater monitoring that you preformed on your own should be reported here.) <br />Monitoring Results Attached: X 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 evaluate <br />the information submitted. Based on my inquiry of the person or persons who manage the system, or those <br />persons directly responsible for gathering the information, the information submitted is, to the best of my <br />knowledge and belief, true, accurate, and complete I am aware that there are significant penalties for submitting <br />false informati^ including the possibility of fine and imprisonment for knowing violations." <br />respon <br />Don Carlson <br />STORMWATER ANNUAL REPORT — SAND AND GRAVEL <br />C:1Documents and Settingsystoupa%Local SethngsxTemporary Intemet Res \Content OutlookUEl.H5HB7\2011 Report.doc 09/25/2007 <br />