Prepared by: [Name] [Address] [Phone] Revisions to Final Approved Site Management Plan: Revision Date NYSDEC No. Submitted Summary of Revision Approval Date Year] CERTIFICATION STATEMENT i __________________certify that I am currently a [NYS registered professional engineer or Qualified Environmental Professional as in defined in 6 NYCRR Part 375] and that this Site Management Plan was prepared in accordance with all applicable statutes and regulations and in substantial conformance with the DER Technical Guidance for Site Investigation and Remediation (DER-10). ________________________ [p.E., qep] ________________________Date
Prepared by: [Name] [Address] [Phone] Revisions to Final Approved Site Management Plan: Revision No. Date Submitted Summary of Revision NYSDEC Approval Date Year] CERTIFICATION STATEMENT i __________________certify that I am currently a [NYS registered professional engineer or Qualified Environmental Professional as in defined in 6 NYCRR Part 375] and that this Site Management Plan was prepared in accordance with all applicable statutes and regulations and in substantial conformance with the DER Technical Guidance for Site Investigation and Remediation (DER-10). ________________________ [p.E., qep] ________________________Date
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