240-25 Exibit A and B.pdf

WQM003-T E. CERTIFICATION BY THE DISTRICT SLUDGE MANAGEMENT LEAD PLANNING AGENCY Note: This certification is only required for applications that involve construction of residual management units at ultimate residuals management sites. Name of Facility/Site/Project: Certifying Statement: “As an authorized representative of the below identified agency, I hereby certify that the agency consents to the submission of the above listed application to the Department of Environmental Protection for approval. I further certify that the project as proposed conforms with the requirements of this agency.” Name of Agency 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