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Inst 2014270289
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Inst 2014270289
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Last modified
11/26/2014 2:12:27 PM
Creation date
11/26/2014 2:12:26 PM
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CM City Clerk-City Council
CM City Clerk-City Council - Document Type
Agreement
Document Date (6)
4/11/2014
Recorded Document Type
Stormwater Treatment
Retention
PERM
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V: Sediment Removal <br /> Total amount of accumulated sediment removed from the stormwater treatment measure(s)during the <br /> reporting period: cubic yards. <br /> The sediment was removed and disposed as follows: <br /> VI. Inspector Information: <br /> The inspections documented in the attached inspection checklists were conducted by the following <br /> inspector(s): <br /> Inspection Date pect r Name and Title Inspector's Emp •ye and Address <br /> 0 VII. Sta 1-me 1i o f I at , • •. ur I on, it on <br /> Based on the •1 speedo •do lumen d i e a :c,ed ii e kli• s is(. e)the` e:tm:: te entified <br /> in this report pr- -• ctio I t. a -- i -d •` •- ai _ ceck yes or <br /> no.) <br /> YES NO <br /> If"NO",describe problem,proposed solution and schedul• r orrection: <br /> VIII. Certification: <br /> I hereby certify,under penalty of perjury,that the information presented in this report and attachments is <br /> true and complete: <br /> Signature of Property Owner or Other Responsible Party Date <br /> Type or Print Name <br /> Company Name <br /> Address <br /> Phone number: Email: <br /> Attach Inspection Checklists <br /> Aurora Cottage 8 13533-13547 Aurora Dr. <br />
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