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5. Sediment Removal: <br /> Total amount of accumulated sediment removed from the stormwater treatment <br /> measure(s)during the reporting period: cubic yards. <br /> The sediment was removed and disposed as follows: Sediment will be removed from <br /> site and disposed of properly. <br /> 6. Inspector Information: <br /> The inspections documented in the attached inspection checklists were conducted by <br /> following inspector(s): <br /> Inspection Date: Inspector Name and Title: Inspector's Employer& <br /> Address: <br /> TBD <br /> 7. Statement of Treatment Measure Condition: <br /> Based on the inspection documented in the attached checklists is (are) the treatment <br /> measure(s) identified in this report present functional and being maintained as <br /> required by the Maintenance Plan? (Check yes or no.) <br /> YES NO <br /> If"NO",describe problem,proposed solution and schedule of correction: <br /> 8. Certification: <br /> I hereby certify.Under penalty of perjury,that the information presented in this report <br /> and attachments is true and complete: <br /> Signature of Property Owner of Other Responsible Party Date <br /> Type or Print Name <br /> Company Name <br /> Address <br /> Phone Number: Email: <br /> Attached: <br /> Stormwater BMP Inspection and Maintenance Log <br />