Stormwater Pollution Prevention Program (Swppp) Template (Page 29 of 30) in pdf

Stormwater Pollution Prevention Program (Swppp) Template Page 29

6. C

eCtion

ertifiCation and

otifiCation

’

Wner

erTIfIcaTIon

I herby certify that I am the owner of the property described in this plan, or their legally authorized agent, and

that I assume full responsibility for the performance of the operation stated in this plan.

Owner: ____________________________________________________________________________________

By: _______________________________________________________________________________________

Title: _____________________________________________________ Date: _________________________

Owner’s Signature: __________________________________________________________________________

’

onSulTanT

eclaraTIon

I herby declare that the site plan, location map, and information contained in sections 1 and 2 of this SWPPP has

been prepared under my direction or supervision in accordance with Boone County’s Regulations, and applica-

ble State and Federal Regulations and that the information submitted is, to the best of my knowledge and belief,

true, accurate, and complete.

Consultant: ________________________________________________________________________________

By: _______________________________________________________________________________________

Title: _____________________________________________________ Date: _________________________

Consultant’s Signature: _______________________________________________________________________

Place Seal Here

’

eneral

onTracTor

erTIfIcaTIon

I herby certify that I understand the requirements stated in this plan, that I am responsible for completing the

requirements set forth in this SWPPP and shown on the site plan, and that I am responsible for the performance

of the subcontractors listed in the plan.

General Contractor: __________________________________________________________________________

By: _______________________________________________________________________________________

Title: _____________________________________________________ Date: __________________________

Contractor’s Signature: _______________________________________________________________________

Stormwater Pollution Prevention Program (Swppp) Template Page 29