240-25 Exibit A and B.pdf

WQM003-T C. CERTIFICATION BY THE WASTEWATER CONVEYANCE SYSTEM OWNER Note: This certification must be completed by the owner/operator of the wastewater conveyance system into which the project named herein will directly connect. Name of Facility/Site/Project: Verona Township WWTF Upgrades Project Certifying Statement: “By agreeing to accept wastewater from the project, I hereby certify that to the best of my knowledge the wastewater conveyance system, into which the project proposed under this application will connect, has adequate capacity in accordance with N.J.A.C. 7:14A-1.2 ("Adequate conveyance capacity"). Furthermore, I am not aware of inadequate conveyance capacity conditions in any portion of the downstream facilities necessary to convey the wastewater from this project to the treatment plant.” Township of West Orange Name of Municipality or Authority Signature of Authorized Representative * Date Print or Type Name Print or Type Position Email Telephone * Authorization to sign for the agency: Resolution # Date (Note: Submit the resolution with this certification. If no such resolution granting authority to sign exists, the full resolution, consenting to the project, must be submitted with this certification.) Last Revised: 8/29/2023