![]() ![]() I certify my electronic signature is for myown use, will keep it confidential, and will not delegate or share with any other person. I agree, onbehalf of myself and the facility identified above to be bound by its terms.I agree to protect my electronic signature from unauthorized use, and I will contact theWater Board, within 24-hours of discovery, if I suspect that my electronic signature hasbeen lost, stolen, or otherwise compromised. I understand that I am legally bound, obligated, or responsibleby use of my electronic signature as much as by a hand-written signature. Mysignature on this form also certifies that my SMARTS user ID and password constitutemy electronic signature and any information I indicate I am electronically certifyingcontains my signature. Data Submitter Person Name: _ Email Address: _Legally Responsible Person Signature:I certify that I am the legally authorized representative for the facility listed below. Data Submitter Person Name: _ Email Address: _6. Data Submitter Person Name: _ Email Address: _5. Data Submitter Person Name: _ Email Address: _Ĥ. Data Submitter Person Name: _ Email Address: _3. ![]() Data Submitter Person Name: _ Email Address: _2. Approved Signatory Person Name: _ Email Address: _Data Submitter Information (please print clearly)1. Approved Signatory Person Name: _ Email Address: _2. SMARTS LRP AUTHORIZATION FORMOperator Information (please print clearly) Name: _ PREFIX, FIRST, MIDDLE, LAST, Address: _ City, State, Zip: _ Phone Number: _ FAX Number: _ E-Mail Address: _ The Water Board will use this email address to send registration informationFacility Information (please print clearly) WDID: _ Name: _ Address: _ City, State, Zip: _ APPROVED SIGNAOTRY AND DATA SUBMITTER(S) IDENTIFICATIONApproved Signatory (please print clearly)1. Box 1977 Sacramento, CA 95812If you have any questions please contact us at 1-86 or Mail the authorization form to: SMARTS Registration P.O. Upon receipt of this Authorization Form, Water Board staffwill email instructions on how to register for SMARTS, a Secret Code Number (SCN),how to link WDID number(s), Approved Signatories or Data Submitters to your account.One authorization form per WDID number is required. A data submitter may be other employees, contractors, labs, etc.A data submitter cannot certify the Annual Report.To register as an LRP and identify Approved Signatory(ies) or Data Submitter(s), youmust have a user account. ![]() An Approved Signatory cannot be a contractoror consultant.A Data Submitter is any individual authorized by the LRP to enter data into SMARTSon behalf of the LRP. An approved signatory maybe other employees designated authority tocertify documents on behalf of the LRP. In the simplest terms, the LRP is the individual thatcertifies the Notice of Intent (NOI) and is responsible for reviewing, validating andcertifying the annual report for accuracy and correctness before it is submitted.The LRP may assign rights to submit and certify the annual report to an ApprovedSignatory. These instructions are for registration of SMARTS LegallyResponsible Person.You must be the Legally Responsible Person (LRP) to submit and certify a SMARTSreport on the behalf of a facility. Legally Responsible Person SMARTS RegistrationThe Storm Water Multi–Application & Report Tracking System (SMARTS) is nowavailable for dischargers to create a user account online and submit Annual Report(s)electronically. ![]()
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