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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 x,-.pect9rName and Title Inspector's Emp .ye and Address <br /> (Th' <br /> �. <br /> nJ <br /> VII. Sta -mef I ,at a 1=•surefoniiton <br /> Based on the i i spectio :°ado.umen •d i t eat c ed e khs is(. e)th 4 ire;tm:nt easure( '`identified <br /> g Y i <br /> in this report pr- • ,.: 'nctfo . nt.' .'a .o i i-d . .••_ ai .nce ' _ Check yes or <br /> no.) <br /> YES NO <br /> If"NO",describe problem,proposed solution and schedule'of correction: <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 /> C:\Users\Sam Valdivia\Dropbox\Projects\Todd's Projects\2009 Farallon\Permits\O&M Agreement for treat meas.doc 8 <br />