2020-07-22 CC Packet - Laserfiche WebLink

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Q77 Any performance issues and corrective action(s), including the date(s) when corrective action(s) were taken, between January 1, 2019, and December 31, 2019: Partnerships Q78 Did you rely on any other regulated MS4s to satisfy one or more Permit requirements? Q79 If'Yes' in Q78, describe the agreements you have with other regulated MS4s and which Permit requirements the other regulated MS4s help satisfy: [Part IV.B.6.] Cooperation with RCWD Additional information Yes If you would like to provide any additional files to accompany your annual report, use the space below to upload those files. For each space, you may attach one file. You may provide additional explanation and/or information in an email with the subject You rMS4NameHere_2019AR to ms4permitprogram. pca(r_state.mn.us. Q80 If a file was successfully uploaded, a reference number will appear: Q81 If a file was successfully uploaded, a reference number will appear: Q82 If a file was successfully uploaded, a reference number will appear: Q83 Optional, describe the file(s) uploaded: Owner of operator certification The person with overall administrative responsibility for SWPPP implementation and Permit compliance must certify this MS4 Annual Report. This person must be duly authorized and should be either a principal executive (i.e., Director of Public Works, City Administrator) or ranking elected official (i.e., Mayor, Township Supervisor). I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete (Minn. R. 7001.0070). 1 am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment (Minn. R. 7001.0540)? By typing my name in the following box, l certify the above statements to be true and correct, to the best of my knowledge, and that information can be used for the purpose of processing my MS4 Annual Report. Name: Paul Palzer Title: Public Works Director Date: 2/6/2020 Yes httPs://www.pca.state.mn.us wq-strm4-06 • 213120 • 651-296-6300 800-657-3864 Use your preferred relay service Available in alternative formats Page 9 of 9