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Monitoring and Reporting Program No. R5-2009-0097 - 3 - <br /> Conditional Waiver of Waste Discharge Requirements for. <br /> Small Food Processors and Small Wineries <br /> actions and/or a time schedule for implementing the corrective actions, reference to the <br /> previous-correspondence will be satisfactory. <br /> If the Discharger elects not to use the attached monitoring report form, a transmittal letter <br /> shall accompany each Annual Monitoring Report. The letter shall clearly identify the. <br /> Discharger name, facility name, mailing address, and county. The transmittal letter shall . <br /> contain the following statement and the signature of the Discharger or the Discharger's <br /> I authorized representative: <br /> "I certify under penalty of law that this document and all attachments were prepared <br /> under my direction or supervision in accordance with a system designed to assure.that <br /> qualified personnel properly gather and evaluate the information submitted. Based on <br /> my inquiry of,the person or persons who manage the system, or those persons directly <br /> responsible for gathering the information, the information submitted is,. to.the best of <br /> my knowledge and belief, true, accurate,.and complete. I am aware that there are <br /> significant penalties for submitting false information, including the possibility of fine and <br /> imprisonment for knowing violations." <br /> The Discharger shall implement the above monitoring program as of the date of coverage <br /> Linder the.Waiver. <br /> Original signed by <br /> PAMELA C. CREEDON, Executive Officer <br /> 8 October 2009 <br /> Date <br /> ALO: AMENDED 10/15/09 <br /> ` <br /> iI - <br /> f <br /> 1 <br />