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MS4 SWPPP Acceptance Form - continued V. Certification Statement - MS4 Official (principal executive officer or ranking elected official) or Duly Authorized Representative I hereby certify that the final Stormwater Pollution Prevention Plan (SWPPP) for the construction project identified in section II. of this form has been reviewed and meets the substantive requirements in the SPDES General Permit for Stormwater Discharges from Construction Activity, GP-0-25-001 (CGP). Note: The MS4 Operator, through the acceptance of the SWPPP, assumes no responsibility for the accuracy and adequacy of the design included in the SWPPP. In addition, review and acceptance of the SWPPP by the MS4 Operator does not relieve the owner/operator or their SWPPP preparer of responsibility or liability for errors or omissions in the plan. Printed Name1: Title/Position: Signature: Date: VI. Additional Information 1 Printed name of the principal executive officer or ranking elected official for the MS4 Operator or their duly authorized representative in accordance with CGP Part VII.J.2. (NYSDEC - MS4 SWPPP Acceptance Form - January 2025) Page 2 of 2 Page 151 of 359