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WA ST Dept of Ecology 5/28/2025
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WA ST Dept of Ecology 5/28/2025
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Entry Properties
Last modified
6/20/2025 10:08:13 AM
Creation date
6/20/2025 10:08:01 AM
Metadata
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Template:
Contracts
Contractor's Name
WA ST Dept of Ecology
Approval Date
5/28/2025
Department
Public Works
Department Project Manager
Jeff Mars/Chris Merwede
Subject / Project Title
NPDES Permit WA0024490; WPCF Signature Authorization
Tracking Number
0004859
Total Compensation
$0.00
Contract Type
Agreement
Contract Subtype
Other Agreements
Retention Period
6 Years Then Destroy
Imported from EPIC
No
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s Vert �.,.''s ,N A�� 4" a* 8 `»'41: .;z`.. ' <br /> All submittals to the Department of Ecology under this WQWebPortal application are subject to the <br /> following certification, as required by federal and state regulations: <br /> I certify under penalty of law that this document and all attachments were prepared under my direction or <br /> supervision in accordance with a system designed to assure that qualified personnel properly gather and <br /> evaluate the information submitted. The information submitted is, to the best of my knowledge and belief, <br /> true, accurate, and complete and I am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment for knowing violations. <br /> .0 <br /> I agree that I will: I agree that I will not: <br /> • Protect my Electronic Signature account,which • Let anyone else use my Electronic Signature <br /> includes my answers to the verification questions account. <br /> and my password; <br /> • Review the content and meaning of my <br /> submitted Annual Reports and Notifications; <br /> • Within 24 hours of discovery, report to Ecology if: <br /> • My Electronic Signature account is lost, <br /> stolen or used by someone else; <br /> • There is any difference between the <br /> information I submitted and the information <br /> displayed in WebDMR; <br /> • My role as a signer for this organization <br /> changes. <br /> Agree: (���� (initial here) Agree:__AV (initial here) <br /> Chris Merwede <br /> I, (print Electronic Signer's name), understand that: <br /> 1. My electronic signature is legally the same as my handwritten signature for the purpose of <br /> compliance with the relevant environmental regulations; <br /> 2. A failure to timely notify Ecology of a possible misuse of my Electronic Signature account may <br /> result in my liability for the information submitted; <br /> 3. There are significant penalties for submitting false information, including possible fines and <br /> imprisonment, related to the federal Department of Justice and federal environmental program; <br /> 4. I will be asked to verify that I am following the rules outlined in this agreement when I <br /> electronically submit documents. <br /> 10/2024 ECY070-743 Page 2 of 4 <br />
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