12.07.2015 Views

Storm Water Pollution Prevention Plan (SWPPP) - the City of Lompoc!

Storm Water Pollution Prevention Plan (SWPPP) - the City of Lompoc!

Storm Water Pollution Prevention Plan (SWPPP) - the City of Lompoc!

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Owner’s (or Authorized Representative)Approval and Cerification <strong>of</strong> <strong>the</strong><strong>Storm</strong> <strong>Water</strong> <strong>Pollution</strong> <strong>Prevention</strong> <strong>Plan</strong>Project Name: Municipal <strong>Water</strong> Well #11 and Transmission <strong>Water</strong>MainI certify under penalty <strong>of</strong> law that this document and all attachmentswere prepared under my direction or supervision in accordance with asystem designed to assure that qualified personnel properly ga<strong>the</strong>rand evaluate <strong>the</strong> information submitted. Based on my inquiry <strong>of</strong> <strong>the</strong>person or persons who manage <strong>the</strong> system or those persons directlyresponsible for ga<strong>the</strong>ring <strong>the</strong> information, to <strong>the</strong> best <strong>of</strong> my knowledgeand belief, <strong>the</strong> information submitted is, true, accurate, and complete. Iam aware that <strong>the</strong>re are significant penalties for submitting falseinformation, including <strong>the</strong> possibility <strong>of</strong> fine and imprisonment forknowing violations.Owner (or Authorized Representative) SignatureDateName and TitleTelephone NumberAuthorized Representative (if applicable)Name:Telephone Number:Area <strong>of</strong> Responsibility:Qualifications:I certify that <strong>the</strong> above named is my Authorized Representative for this<strong>SWPPP</strong>.Owner SignatureDate

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