14-18 Exhibit-Application for Discharge Site Remediation Funds from HDSRF.pdf

New Jersey Department of Environmental Protection Site Remediation Program HDSRF APPLICATION – INNOCENT PARTY GRANT CERTIFICATION – PART IV THIS CERTIFICATION IS REQUIRED FOR ALL APPLICANTS APPLYING FOR AN INNOCENT PARTY GRANT This certification shall be signed as follows: for a corporation, by a principal executive officer, at least the level of vice president; for a partnership, by a general partner; for a sole proprietorship, by the proprietor; for other than above (i.e. homeowner/individual), the person with legal responsibility for the site. I hereby certify that A) I (the applicant) acquired the property prior to December 31, 1983; B) I (the applicant) own and will continue to own the property until NJEDA approves the grant; C) The hazardous substance or hazardous waste that was discharged at the property was not used by the me (the applicant) or by any person with permission to use the property; and D) I (the applicant), or any person I gave permission to use the property, did not discharge any hazardous substance or hazardous waste at an area where a discharge is or has been discovered. Signature Name/Title Company Sworn to and Subscribed Before Me On this date of Notary HDSRF Application Part IV Page 1 of 1 Version 1.3 12/11/13