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Stormwater Pollution Prevention Plan Subcontractor Certification Statement (whose work involves soil disturbance) West Seneca Town of West Seneca, Erie County, New York Each Subcontractor whose work will involve soil disturbance of any kind is required to complete and sign this Certification Statement before commencing any construction activity at the site. This completed Certification Statement(s) shall be maintained at the construction site in the Site Log Book. Subcontracting Firm Information Name: Address: Telephone & Fax: Trained Contractor(s) 2 Responsible for SWPPP Implementation (Provide name, title, and date of last training) Prior to commencement of construction activities, the following certification shall be issued: I hereby certify under penalty of law that I understand and agree to comply with the requirements of the SWPPP and agree to implement any corrective actions identified by the qualified inspector during a site inspection. I also understand that the owner or operator must comply with the requirements of the most current version of the New York State Pollutant Discharge Elimination System (SPDES) Construction General Permit (CGP) for Stormwater Discharges from Construction Activities and that it is unlawful for any person to cause or contribute to a violation of water quality standards. Furthermore, I am aware that there are significant penalties for submitting false information, that I do not believe to be true, including the possibility of fine and imprisonment for knowing violations Printed Name: Title/Position: Signature: Date: 2 “Trained Contractor” means an employee from a contracting (construction) company that has received four (4) hours of Department endorsed training in proper erosion and sediment control principles from a Soil and Water Conservation District, or other Department endorsed entity. After receiving the initial training, the “trained contractor” shall receive four (4) hours of training every three (3) years. It can also mean an employee from the contracting (construction) company that meets the “qualified inspector” qualifications (e.g. licensed Professional Engineer, Certified Professional in Erosion and Sediment Control (CPESC), Registered Landscape Architect, New York State Erosion and Sediment Control Certificate Program holder, or someone working under the direct supervision of, and at the same company as, the licensed Professional Engineer or Registe red Landscape Architect, provided they have received four (4) hours of Department endorsed training in proper erosion and sediment control principles from a Soil an d Water Conservation District, or other Department endorsed entity). The “Trained Contractor” will be responsible for the day to day implementation of the SWPPP. Page 155 of 359