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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): F-1 <br />Inspection Date/ I ,^pectJr Name and Title I Inspector's Emp�byejjand Address <br />VII. Sta meiatkf . atn e�`t sur - on it on `t i <br />Based on the f spectio do umen d i t e a c ed h kli s is( e) th re tm t easure( identified <br />in this report pr nctio t ' i d ai nce 'heck yes or <br />no.) <br />YES NO <br />If "NO", describe problem, proposed solution and schedulTUftorrection: <br />Vill. 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 />9 <br />P12700 - 2799\2719-OOO1EngineednglSWMP\O&M\2nd Su6mittallO & M Agreement for treat meas 04252019_parrott.doc <br />