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I <br /> IThe Bethany at Silver Lake <br /> Stormwater Pollution Prevention Plan <br /> IInspection and Maintenance Report Form <br /> I Changes-re required to the pollutionprevention plan: <br /> q p <br /> I <br /> I <br /> I <br /> Reasons for changes: <br /> I • <br /> I <br /> I <br /> II certify under penalty of law that this document and all attachments were prepared under my <br /> direction or supervision in accordance with a system designed to assure that qualified personnel <br /> properly gathered and evaluated the information submitted. Based on my inquiry of the person <br /> I or persons who manage the system, or those persons directly responsible for gathering the <br /> information, the information submitted is, to the best of my knowledge and belief, true, accurate, <br /> and complete. I am aware that there are significant penalties for submitting false information, <br /> including the possibility of fine and imprisonment for knowing violations. <br /> I <br /> Signature: Date: <br /> I <br /> I <br /> I <br /> I <br /> IConstruction Stormwater Pollution Prevention Plan <br /> The Bethany at Silver Lake Exhibit 1 -3 OCIOfil <br /> 2180406.10 <br />