NCS000543_SIGNED SP3 Certification_20170925

STORMWATER POLLUTION PREVENTION PLAN
DEVELOPMENT AND IMPLEMENTATION
CERTIFICATION
North Carolina Division of Energy, Mineral, and Land Resources — Stormwater Permitting
Facility Name:
Permit Number:
Location Address:
Carus Corporati
NCS 000543
181 Woodlawn Street. Belmont. NC 28012
County: Gaston
"I certify, under penalty of law, that the Stormwater Pollution Prevention Plan (SPPP) document and all attachments were
developed and implemented under my direction or supervision in accordance with a system designed to assure that qualified
personnel properly gather and evaluate the information required by the SPPP. Based on my inquiry of the person or persons
who manage the system, or those persons directly responsible for gathering the information, the information gathered is, to the
best of my knowledge and belief, true, accurate and complete."
And
"I certify that the SPPP has been developed, signed and retained at the named facility location, and the SPPP has been fully
implemented at this facility location in accordance with the terms and conditions of the stormwater discharge permit."
And
"I am aware that there are significant penalties for falsifying information, including the possibility of fines and imprisonment for
knowing violations."
Sign (according to permit signatory requirements) and return this Certification. DO NOT
SEND STORMWATER POLLUTION PREVENTION PLAN WITH THIS CERTIFICATION.
Signature TbeAk
Mark (:nrhmn
Print or type name of person signing above
Date 1 7
Plant Mgr
Title
SPPP Certification 10/13