Form CONR5 "Contractor / Subcontractor Spdes Permit Certification" - New York

What Is Form CONR5?

This is a legal form that was released by the New York State Department of Transportation - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2019;
  • The latest edition provided by the New York State Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CONR5 by clicking the link below or browse more documents and templates provided by the New York State Department of Transportation.

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Download Form CONR5 "Contractor / Subcontractor Spdes Permit Certification" - New York

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CONR 5
Contractor / Subcontractor SPDES Permit Certification
(10/19)
Contract No.:
PIN:
Description:
Town, Village, City:
County:
Prime Contractor
Subcontractor
Check Applicable Box:
Name of Contractor/
Subcontractor:
Address:
City:
State:
ZIP:
Phone:
Fax:
Core Pay Item Groups for which the Contractor/Subcontractor will be responsible (e.g. 203, 207,
209, etc.):
Mandatory Certification: The SPDES General Permit for Stormwater Discharges from Construction Activities
requires the Prime Contractor and subcontractors to certify they understand the Stormwater Pollution Prevention
Plan (SWPPP), the General Permit conditions, and their responsibilities for compliance. The certification must be
signed prior to performing any contract work. The certification shall be signed by an Owner, Principal, President,
Secretary or Treasurer of the firm in accordance with the signature requirements of 102-05 Proposal Submission
of the Standard Specifications.
"I hereby certify under penalty of law that I understand and agree to comply with the terms and conditions of the
SWPPP and agree to implement any corrective actions identified by the qualified inspector during a site inspection.
I also understand that the owner or operator must comply with the terms and conditions of the most current version
of the New York State Pollutant Discharge Elimination System ("SPDES") general permit for stormwater discharges
from construction activities and that it is unlawful for any person to cause or contribute to a violation of water quality
standards. Furthermore, I am aware that there are significant penalties for submitting false information, that I do
not believe to be true, including the possibility of fine and imprisonment for knowing violations."
Signature:
Date:
Name:
Title:
Required Training: Effective April 30, 2010, the SPDES General Permit also requires the Prime Contractor and all subcontractors
performing earthwork or soil-disturbing activities to identify at least one trained individual from each company who will be
responsible for implementing the SWPPP and who shall be on-site on a daily basis when the company is performing soil
disturbance activities. These activities include clearing, grubbing, grading, filling, excavation, stockpiling, demolition, landscaping,
and installation and maintenance of Erosion & Sediment Control practices. Training must consist of 4 hours of
NYSDEC-endorsed Erosion & Sediment Control Training every 3 years. (Training is not required if the individual is a licensed
Professional Engineer, registered licensed Landscape Architect, or CPESC.) Provide the information below for trained
individuals
who will be on-site and responsible for SWPPP implementation on this Contract (attach a separate sheet if needed for additional
Trained Individuals):
Trained Individual Name/Title :
Name of Training Course:
Trainee Number:
Date of Training:
Trained Individual Name/Title :
Name of Training Course:
Trainee Number:
Date of Training:
Print Form
Make Form Read-Only (Cannot be undone)
CONR 5
Contractor / Subcontractor SPDES Permit Certification
(10/19)
Contract No.:
PIN:
Description:
Town, Village, City:
County:
Prime Contractor
Subcontractor
Check Applicable Box:
Name of Contractor/
Subcontractor:
Address:
City:
State:
ZIP:
Phone:
Fax:
Core Pay Item Groups for which the Contractor/Subcontractor will be responsible (e.g. 203, 207,
209, etc.):
Mandatory Certification: The SPDES General Permit for Stormwater Discharges from Construction Activities
requires the Prime Contractor and subcontractors to certify they understand the Stormwater Pollution Prevention
Plan (SWPPP), the General Permit conditions, and their responsibilities for compliance. The certification must be
signed prior to performing any contract work. The certification shall be signed by an Owner, Principal, President,
Secretary or Treasurer of the firm in accordance with the signature requirements of 102-05 Proposal Submission
of the Standard Specifications.
"I hereby certify under penalty of law that I understand and agree to comply with the terms and conditions of the
SWPPP and agree to implement any corrective actions identified by the qualified inspector during a site inspection.
I also understand that the owner or operator must comply with the terms and conditions of the most current version
of the New York State Pollutant Discharge Elimination System ("SPDES") general permit for stormwater discharges
from construction activities and that it is unlawful for any person to cause or contribute to a violation of water quality
standards. Furthermore, I am aware that there are significant penalties for submitting false information, that I do
not believe to be true, including the possibility of fine and imprisonment for knowing violations."
Signature:
Date:
Name:
Title:
Required Training: Effective April 30, 2010, the SPDES General Permit also requires the Prime Contractor and all subcontractors
performing earthwork or soil-disturbing activities to identify at least one trained individual from each company who will be
responsible for implementing the SWPPP and who shall be on-site on a daily basis when the company is performing soil
disturbance activities. These activities include clearing, grubbing, grading, filling, excavation, stockpiling, demolition, landscaping,
and installation and maintenance of Erosion & Sediment Control practices. Training must consist of 4 hours of
NYSDEC-endorsed Erosion & Sediment Control Training every 3 years. (Training is not required if the individual is a licensed
Professional Engineer, registered licensed Landscape Architect, or CPESC.) Provide the information below for trained
individuals
who will be on-site and responsible for SWPPP implementation on this Contract (attach a separate sheet if needed for additional
Trained Individuals):
Trained Individual Name/Title :
Name of Training Course:
Trainee Number:
Date of Training:
Trained Individual Name/Title :
Name of Training Course:
Trainee Number:
Date of Training:
Print Form
Make Form Read-Only (Cannot be undone)