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STORMWATER ANNUAL REPORT-METAL MINING (& COAL) <br /> Permit Cert.No. COR-04 <br /> Second Inspection - Date_/ / Findings, and action taken: <br /> ?e/J r vd t C ZiRv G-4 Yt ow-re/L. oXcwy S� <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 <br /> results. (Monitoring is not a requirement under the permit,unless you were specifically directed to do so by the <br /> Division. However,the results of any stormwater monitoring that you performed on your own should be reported <br /> here.) <br /> Monitoring Results Attached? 6P 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 the <br /> information submitted. Based on my inquiry of the person or persons who manage the system,or those persons <br /> directly responsible for gathering the information,the information submitted is,to the best of my knowledge and <br /> belief,true,accurate,and complete. I am aware that there are significant penalties for submitting false information, <br /> including the possibility of fine and imprisonment for knowing violations." <br /> -P,(( <br /> Signature of Permittee(legally responsible person) Date Signed <br /> Zove#o- -J'medo- <br /> bz <br /> Name (printed) Title <br /> Use additional pages as needed. Page 2 of 2 ,rF;veic <br />