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STORM WATER POLLUTION PREVENTION PLAN CONTRACTOR’S CERTIFICATION STATEMENT Multifamily Development – 1425 & 1475 Orchard Park Road CONTRACTOR'S CERTIFICATION: “I certify under penalty of law that I understand and agree to comply with the terms and conditions of the SWPPP for the construction site identified in such SWPPP as a condition of authorization to discharge storm water. I also understand that the operator must comply with the terms and conditions of the New York State Pollutant Discharge Elimination System (SPDES) general permit for storm water discharges from construction activities and that it is unlawful for any person to cause or contribute to a violation of water quality standards.” Note: The contractor shall have at least one NYSDEC trained individual onsite at all times when earthwork and other SWPPP associated work is being performed from each contractor(s) and subcontractor(s). Each contractor(s) and subcontractor(s) shall provide copies of these individuals’ certifications to the Town of West Seneca. Name: (Print) Signature: Title: Company Name: Address: ___________________________________ Telephone Number: __________________________ Date: ______________________________________ Scope of Services: Trained Individual(s) Responsible for Implementation: __________________________________________ This form must be signed by a responsible corporate officer or other party meeting the “Signatory Requirements” of the NYSDEC SPDES General Permit Page 800 of 849