"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." Signature __________________________________________________ Date _______________ For questions, contact your local Regional Office: DWQ Regional Office Contact Information: ASHEVILLE REGIONAL OFFICE REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE 70 610 East Center Avenue/Suite 301 (828) 296-4500 (704) 663-1699 (910) 433-3300 REGIONAL OFFICE REGIONAL OFFICE REGIONAL OFFICE Mall Extension (919) 791-4200 (252) 946-6481 (910) 796-7215 REGIONAL OFFICE CENTRAL OFFICE 1617 (336) 771-5000 (919) 807-6300
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." Signature __________________________________________________ Date _______________ For questions, contact your local Regional Office: DWQ Regional Office Contact Information: ASHEVILLE REGIONAL OFFICE 70 (828) 296-4500 REGIONAL OFFICE (910) 433-3300 MOORESVILLE REGIONAL OFFICE 610 East Center Avenue/Suite 301 (704) 663-1699 REGIONAL OFFICE (919) 791-4200 REGIONAL OFFICE Mall (252) 946-6481 REGIONAL OFFICE Extension (910) 796-7215 REGIONAL OFFICE (336) 771-5000 CENTRAL OFFICE 1617 (919) 807-6300
AnnDMR-Generic-20130517-DWQ-SPU.docx