3800-FM-BCW0491 9/2017 Annual MS4 Status Report pennsylvania DEPARTMENTO PROTECTION OFENVIRONMENTAL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF ENVIRONMENTAL PROTECTION BUREAU OF CLEANY WATER ANNUAL MUNICIPAL SEPARATE STORM SEWER SYSTEM (MS4) STATUS REPORT FOR THE PERIOD July 1, 2022 TO JUNE 30, 2023 GENERAL INFORMATION Permittee Name: Mailing Address: City, State, Zip: Title: Phone: Email: Bentleyville Borough 900 Main Street Bentleyville, PA 15314 Borough Secretary 724-239-2112 blvporo@lairpointnet NPDES Permit No.: PAG136337 Effective Date: Expiration Date: Municipality: County: March 16, 2018 March 15, 2023 Bentleyville Borough Washington MS4 Contact Person: Tammy Stamm Renewal Due Date: 9/16/22 - On Hold per DEP Co-Permittees (if applicable): Appendix(ces) that permitteei is subject to (select all that apply): Appendix A D Appendix B D Appendix C D Appendix D R Appendix E Appendix F WATER QUALITY INFORMATION Are there any discharges to waters within the Chesapeake Bay' Watershed? Yes X No Identify all surface waters that receive stormwater discharges from the permittee's MS4 and provide the requested information (see instructions). Receiving Water Name Pigeon Creek North Branch of Pigeon Creek UNT to Pigeon Creek (Reach 002336) UNT to Pigeon Creek (Reach 002327) Ch. 93 Class. Impaired? WWF WWF WWF WWF Cause(s) Acid Mine Drainage Metals Other Than Mercury N/A N/A NIA TMDL? No No No No WLA? No No No No Yes No No No 3800-FM-BCW0491 9/2017 Annual MS4 Status Report GENERAL MINIMUM CONTROL MEASURE (MCM)INFORMATION Have you completed. all MCM activities required byt the permit fort this reporting period? X Yes Contact Name Tammy Stamm No List the current entity responsible fori implementing each MCM of your SWMP, along with contact name and phone number. MCM Entity Responsible Permittee Permittee Permittee Permittee/Code Enforcement Permittee/Code Enforcement Permittee Phone (724)239- 2112 2112 (724)239- 2112 (724)239- 350-2874 (724)239- 350-2874 (724).239- 2112 #1 Public Education and Outreach on Storm' Water Impacts #2 Public nvovemenuParcpation Tammy Stamm (724)239- Tammy Stamm Tammy Stamm/Kerry 2112/(724) Krider Tammy Stamm/Kerry 2112/(724) Krider Mark Bostich #3 Illicit Discharge Detection and Elimination (IDD&E) #4 Construction Site Storm Water Runoff Control #5 Post-Construction Storm' Water Management in New Development and Redevelopment #6 Pollution Prevention / Good Housekeeping MCM #1 - PUBLIC EDUCATION AND OUTREACH ON STORM WATER IMPACTS BMP #1: Develop, implement and maintain a written Public Education and Outreach Program. 1. For new permittees only, has the written PEOP been developed and implemented within thei first year of permit coverage? Yes No 2. Date of latest annual review of PEOP: 9/26/2023 Were updates made? Yes X No 3. What were the plans and goals for public education and outreach fort the reporting period? Educate the public relating to storm water within our community. 4. Did the MS4 achieve its goal(s) for the PEOP during the reporting period? 5. Identify specific plans and goals for public education and outreach for the upcoming year: Educate the public relating to storm water within our community. Yes No BMP #2: Develop and maintain lists of target audience groups present within the areas served by your MS4. 1. For new permittees only, have the target audience lists been developed and implemented within the first year of permit coverage? Yes L No 2. Date of latest annual review of target audience lists: 9/26/2023 Were updates made? Yes R No BMP #3: Annually publish at least one educational item on your Stormwater Management Program. -2- 3800-FM-BCW0491 9/2017 Annual MS4 Status Report 1. For new permittees only, were stormwater educational and informational items produced and published in print and/or on the Internet within thet first year of permit coverage? Yes No 2. Date of latest annual review of educational materials: 9/26/2023 3. Do you have a municipal website? K Yes wbenteypletonpughom Were updates made? X Yes No No (URL: -3- 3800-FM-BCW0491 9/2017 Annual MS4 Status Report IfYes, what MS4-related material does it contain? It does not have specific MS4 information but it does provide access to the Borough Stormwater Management 4. Describe any other method(s) used during the reporting period to provide information on stormwater tot the public: Storm water concerns are discussed with the public during monthly council meetings. Educational flyers are posted Borough representatives have met with individual residents who have voiced specific complaints affecting their properties. The Borough works to assess whether it is a public or private matter and provide the necessary Ordinance. att the Borough building. 5. Identify specific plans for the publication of stormwater materials for the upcoming year: education to assist with solutions to the concerns. BMP #4: Distribute stormwater educational materials to the target audiences. Identify the two additional methods of distributing stormwater educational materials during the previous reporting period (e.g., displays, posters, signs, pamphlets, booklets, brochures, radio, local cable TV, newspaper articles, other advertisements, bill stuffers, posters, presentations, conferences, meetings, fact sheets, giveaways, or storm drain stenciling). Pamphlets and Posters MCM #1 Comments: MCM #2-PUBLIC INVOLVEMENT/PARTICIPATION BMP #1: Develop, implement and maintain a written Public Involvement and Participation Program (PIPP) 1. For new permittees only, was the PIPP developed and implemented within one year of permit coverage? Yes No 2. Date ofl latest annual review of PIPP: 9/26/2023 Were updates made? Yes K No BMP #2: Advertise to the public and solicit public input on ordinances, SOPs, Pollutant Reduction Plans (PRPs) (if applicable) and TMDL Plans (if applicable), including modifications thereto, prior to adoption or submission to DEP: 1. Was an MS4-related ordinance, SOP, PRP or TMDL Plan developed during the reporting period? a Yes K No 2. IfYes, describe how you advertised the draft document(s) and how you provided opportunities for public review, input and feedback: 3. Ifan ordinance, SOP or plan was developed or amended during the reporting period, provide the following information: Ordinance /SOP/Plan Name Date of Public Notice 4- Date of Public Hearing Date Enacted or Submitted to DEP 3800-FM-BCW0491 9/2017 Annual MS4 Status Report 3800-FM-BCW0491 9/2017 Annual MS4 Status Report BMP #3: Regularly solicit public involvement and participation from the target audience groups using available 1. At least one public meeting or other MS4 event must be held during the 5-year permit coverage period to solicit participation and feedback from target audience groups. Was this meeting or event held during the reporting period? 2. Report instances of cooperation and participation in MS4 activities; presentations the permittee made to local watershed and conservation organizations; and similar instances of participation or coordination with organizations ini the community. The Board of Supervisors meets with individual residents who have voiced specific complaints affecting their properties. The Borough works to assess whether it is a public or private matter and provide the necessary 3. Report activities in which members of the public assisted or participated in the meetings and in the implementation of the SWMP, including education activities or efforts such as cleanups, monitoring, storm drain stenciling, or others. distribution and outreach methods. Yes X No IfYes, Date of Meeting or Event: education to assist with solutions to the concerns. NA MCM #2 Comments: MCM# #3-ILLICIT DISCHARGE DETECTION AND ELIMINATION (IDD&E) BMP #1: Develop and implement a written program for the detection, elimination, and prevention of illicit discharges 1. For new permittees only, was the written IDD&E program developed within one year of permit coverage? into the regulated small MS4. Yes No 2. Date ofl latest annual review of IDD&E, program: 9/26/2023 Were updates made? Yes R No BMP #2: Develop and maintain map(s) that show permittee and urbanized area boundaries, the location of all outfalls and, if applicable, observation points, and the locations and names of all surface waters that receive discharges from those outfalls. Outfalls and observation points shall be numbered on the map(s). 1. Have you completed a map(s) thati includes all components of BMP #2? R Yes - No If Yes and you are a new permittee and have not submitted the map(s) previously, attach the map(s) to this report. IFNo, date by which permittee expects map(s) to be completed: 2. Date of last update or revision to map(s): 1/15/2018 3. Total No. of Outfalls in MS4: 35 4. Total No. of Observation Points: 14 Total No. of Outfalls Mapped: 35 Total No. of Observation Points Mapped: 14 5. During the reporting period, have you identified any existing outfalls that have not been previously reported to DEP in an NOI, application or annual report, or are any new MS4 outfalls proposed for the next reporting period? Yes X No IfYes, select: Existing Outfall(s) Identified New Outfall(s) Proposed 6 3800-FM-BCW0491 9/2017 Annual MS4 Status Report BMP #3: In conjunction with the map(s) created under BMP #2 (either on the same map or on a different map), the permittee shall develop and maintain map(s) that show the entire storm sewer collection system within the permittee's jurisdiction that are owned or operated by the permittee (including roads, inlets, piping, swales, catch basins, channels, and any other components of the storm sewer collection system), including privately-owned components of the collection system where conveyances or BMPs on private property receive stormwater flows from upstream publicly-owned components. 1. Have you completed a map(s) that includes all components of BMP #3? R Yes LJ No If Yes andy you are ar new permittee and have not submitted the map(s) previously, attachi the map(s) to this report. IfNo, date by which permittee expects map(s) to be completed: 2. IfYest to #1, is the map(s) on the same map(s) as for outfalls and receiving waters? R Yes No 3. Date ofl last update or revision to map(s): 2021 BMP #4: Conduct dry weather screenings of MS4 outfalls to evaluate the presence of illicit discharges. If any illicit discharges are present, the permittee shall identify the source(s) and take appropriate actions to remove or correct any illicit discharges. The permittee shall also respond to reports received from the public or other agencies of suspected or confirmed illicit discharges associated with the storm sewer system, as well as take enforcement action as necessary. The permittee shall immediately report to DEP illicit discharges that would endanger users downstream from the discharge, or would otherwise result in pollution or create a danger of pollution or would damage property. For new permittees, all identified outfalls (and if applicable observation points) must be screened during dry weather at least twice within the 5-year period following permit coverage. For existing permittees, all identified outfalls (and if applicable observation points) must be screen during dry weather at least once within the 5-year period following permit coverage and, for areas where past problems have been reported or known sources of dry weather flows occur on a continual basis, outfalls 1. How many unique outfalls (and if applicable observation points) were screened during the reporting period? 26 must be screened annually during each year of permit coverage. 2. Indicate the percentage of all outfalls screened in the past five years. 100% 15% 3. Indicate the percent of outfalls screened during the reporting period that revealed dry weatheri flows: 4. Did any dry weather flows reveal color, turbidity, sheen, odor, floating or submerged solids? D Yes K No 5. IfYes for #4, attach all sample results to this report with a map identifying the sample location. Explain the corrective action(s) taken in the attachment. X Yes LZ No 6. Do you use the MS4 Outfall Field Screening Report form 3800-FM-BCW0521) provided in the permit? IfNo, attach a copy of your screening report form. BMP #5: Enact a Stormwater Management Ordinance or SOP to implement and enforce a stormwater management 1. Do you have an ordinance (municipal) or SOP or other mechanism (non-municipal) that prohibits non-stormwater 2. If Yes to #1, is the ordinance or SOP consistent with DEP's 2022 Model Stormwater Management Ordinance (3800-PM- If Yes to #2 andt the ordinance or SOP has not been submitted to DEP previously, attach the ordinance or SOP. program that includes prohibition of non-stormwater discharges to the regulated small MS4. discharges? R Yes D No IfYes, indicate the date of the ordinance or SOP: 4/10/2013 BCW0100j) with respect to authorized non-stormwater discharges? K Yes D No -7- 3800-FM-BCW0491 9/2017 Annual MS4 Status Report 3. Were there any violations oft the ordinance or SOP during the reporting period? Yes No If Yes tot #3, complete the table below (attach additional sheets as necessary). Violation Date Nature of Violation Responsible Party Enforcement Taken 4. Did you approve any waiver or variance during the reporting period that allowed an exception to non-stormwater discharge If Yes to #4, identify the entity that received the waiver or variance and the type of non-stormwater discharge approved. provisions of an ordinance or SOP? D Yes R No BMP #6: Provide educational outreach to public employees, business owners and employees, property owners, the general public and elected officials (i.e., target audiences) about the program to detect and eliminate illicit discharges. 1. Was IDD&E-related information distributed to public employees, businesses, and the general public during the reporting period? D Yes R No IfYes, what was distributed? 2. Is there a well-publicized method for employees, businesses and the public to report stormwater pollution incidents? 3. Doy you maintain documentation of all responses, action taken, and the time required to take action? Yes No Yes R No MCM #3 Comments: No pollution incident reports filed, MCM: #4-CONSTRUCTION SITE STORMWATER RUNOFF CONTROL Are you relying on PA's statewide program for stormwater associated with construction activities to satisfy this MCM? (IF Yes, respond to questions for BMP Nos. 1, 2 and 3 only in this section. IfNo, respond to questions for all BMPS in this BMP #1: The permittee may not issue a building or other permit or final approval to those proposing or conducting earth disturbance activities requiring an NPDES permit unless the party proposing the earth disturbance has valid During the reporting period, did you comply with 25 Pa. Code S 102.43 (relating to withholding building or other permits or R Yes J No section) NPDES Permit coverage (i.e., not expired) under 25 Pa. Code Chapter 102. approvals until DEP or ac county conservation district (CCD) has approved NPDES permit coverage)? Yes No K Not Applicable (no building permit applications received) -8- 3800-FM-BCW0491 9/2017 Annual MS4 Status Report BMP #2: A municipality or county which issues building or other permits shall notify DEP or the applicable CCD within 5d days of the receipt of an application for a permit involving an earth disturbance activity consisting of one acre or During the reporting period, did you comply with 25 Pa. Code S 102.42 (relating to notifying DEP/CCD within 5 days of more, in accordance with 25 Pa. Code S 102.42. reçeiving an application involving an earth disturbance activity of one acre or more)? Yes No Not Applicable (no building permit applications received) control BMPs, including sanctions for non-compliance, as applicable. maintenance of E&S control BMPs? R Yes D No IfYes, indicate the date oft the ordinance or SOP: 4/10/2013 BMP #3: Enact, implement and enforce an ordinance or SOP to require the implementation and maintenance of E&S 1. Do you have an ordinance (municipal) or SOP or other mechanism (non-municipal) that requires implementation and 2. If Yes to #1, is the ordinance or SOP consistent with DEP's 2022 Model Stormwater Management Ordinance (3800-PM- 3. IfYes to #2 and the ordinance or SOP has not been submitted previously, attach a copy oft the ordinance or SOP. BMP #4: Review Erosion and Sediment (E&S) control plans to ensure that such plans adequately consider water BCW0100J)? R Yes LJ No quality impacts and meet regulatory requirements. Specify the number of E&S Plans your reviewed during the reporting period: NA BMP #5: Conduct inspections regarding installation and maintenance of E&S control measures during earth disturbance activities. Maintain records of site inspections, including dates and inspection results, in accordance with the record retention requirements in this permit. Specify the number of E&S inspections you completed during the reporting period: NA activities does not comply with permit andlor regulatory requirements. BMP #6: Conduct enforcement when installation and maintenance of E&S control measures during earth disturbance Specify the number of enforcement actions you took during the reporting period fori improper E&S: NA BMP #7: Develop and implement requirements for construction site operators to control waste at construction sites that may cause adverse impacts to water quality. The permittee shall provide education on these requirements to Specify the method(s) by which you are educating construction site operators on controlling waste at construction sites: construction site operators. NA BMP #8: Develop and implement procedures for the receipt and consideration of public inquiries, concerns, and information submitted by the public to the permittee regarding local construction activities. 1. At tracking system has been established for receipt of public inquiries and complaints. 2. Specify the number of inquiries and complaints received during the reporting period: NA Yes No MCM #4 Comments: 9- 3800-FM-8CW0491 9/2017 Annual MS4 Status Report MCM#5-POST-CONSTRUCTION STORM WATER MANAGEMENT IN NEW DEVELOPMENT AND REDEVELOPMENT BMP #1: Enact, implement and enforce an ordinance or SOP to require post-construction stormwater management 1. Do you have an ordinance (municipal) or SOP or other mechanism (non-municipal) that requires implementation and from new development and redevelopment projects, including sanctions for non-compliance. maintenance of post-construction stormwater management (PCSM) BMPs? R Yes D No IfYes, indicate the date of the ordinance or SOP: 4/10/2013 800-PM-8CW0100)? R Yes No 2. If Yes to #1, is the ordinance or SOP consistent with DEP's 2022 Model Stormwater Management Ordinance 3. IfYes to #2 andt the ordinance or SOP has not been submitted previously, attach a copy oft the ordinance or SOP. BMP #2: Develop and implement measures to encourage and expand the use of Low Impact Development (LID) in new development and redevelopment. Measures should also be included to encourage retrofitting LID into existing development. Enact ordinances consistent with LID practices and repeal sections of ordinances that conflict with LID 1. Do you have an ordinance (municipal) or SOP or other mechanism (non-municipal) that encourages and expands the use practices. ofLID in new development and redevelopment? R Yes D No IfYes, indicate the date of the ordinance or SOP: 4/10/2013 2. If Yes to #1, is the ordinance or SOP consistent with DEP's 2022 Model Stormwater Management Ordinance (3800-PM- 3. IfYest to #2 andi the ordinance or SOP has not been submitted previously, attach a copy of the ordinance or SOP. BMP #3: Ensure adequate 0&M of all post-construction stormwater management BMPs that have been installed at development or redevelopment projects that disturb greater than or equal to one acre, including projects less than 1. Do you have an inventory of all PCSM BMPS that were installed to meet requirements in NPDES Permits for Stormwater Discharges Associated with Construction Activities approved since March 10, 2003? D Yes K No BCW0100)? R Yes D No one acre that are part of a larger common plan of development or sale. If Yes to #1, complete Table 1 on: the next page. 2. Has proper 0&M occurred during the reporting period for all PCSM BMPs? Yes No 3. If No to #2, explain what action(s) the permittee has taken or plans to take to ensure proper 0&M. The Borough does not have PCSM BMPs within our Borough to oversee at this time. Ify you are relying on PA's statewide program for stormwater associated with construction activities, you may skip to MCM #6, BMP #4: Require the implementation of a combination of structural and/or non-structural BMPs that are appropriate to the local community, that minimize water quality impacts, and that are designed to maintain pre-development runoff 1. Specify the number of PCSM Plans reviewed during the reporting period for projects disturbing greater than or equal to one acre (including projects less than one acre that are part of al larger common plan of development or sale): NA 2. Has at tracking system been established and maintained to record qualifying projects and their associated BMPs? otherwise complete all questions for BMPS #4- #6 in this section. conditions. Yes 7- No -10- 5 0 9 10 11 € 1$2 14 5 3800-FM-BCW0491 9/2017 Annual MS4 Status Report BMP #5: Ensure that controls are installed that shall prevent or minimize water quality impacts. The permittee shall inspect all qualifying development or redevelopment projects during the construction phase to ensure proper installation of the approved structural PCSM BMPs. A tracking system (e.g., database, spreadsheet, or written list) shall be implemented to track the inspections conducted and to track the results of the inspections (e.g., BMPs were, 1. During the reporting period have you inspected all qualifying development and redevelopment projects during the or were not, installed properly). construction phase to ensure proper installation of approved structural BMPs? Yes No K Not Applicable (no qualifying projects during reporting period) 2. Has at tracking system been established and maintained to record results of inspections? Yes No BMP #6: Develop a written procedure that describes how the permittee shall address all required components of this Have you developed a written plan that addresses: 1) minimum requirements for use of structural and/or non-structural BMPS in plans for development and redevelopment, 2) criteria for selecting and standards for sizing stormwater BMPs; and 3) MCM. implementation of an inspection program to ensure that BMPS are properly installed? D Yes D No MCM #5 Comments: MCM#6- POLLUTION PREVENTION/GOOD HOUSEKEEPING BMP #1: Identify and document all operations that are owned or operated by the permittee and have the potential for generating pollution in stormwater runoff to the MS4. This includes activities conducted by contractors for the 1. Have you identified all facilities and activities owned and operated by the permitee that have the potential to generate permittee. stormwater runoffi into the MS4? R Yes L No 2. When was the inventory last reviewed? September 2023 3. When was it last updated? 9/25/2018 BMP #2: Develop, implement and maintain a written O&M program for all operations that could contribute to the discharge of pollutants from the MS4, as identified under BMP #1. This program shall address stormwater collection or conveyance systems within the regulated MS4. 1. Have you developed a written O&M program fort the operations identified in BMP #1? K Yes No 2. Date of last review or update to written O&M program: September 2023 BMP #3: Develop and implement an employee training program that addresses appropriate topics to further the goal of preventing or reducing the discharge of pollutants from operations to the regulated small MS4. All relevant employees and contractors shall receive training. 1. Have you developed an employee training program? R Yes D No 2. Date of last review or update to training program: September 2023 Date of latest training: NA -12- 3800-FM-BCW0491 9/2017 Annual MS4 Status Report 3. Training topics covered: NA NA NA 4. Name(s) of training presenter(s): 5. Names of training attendees: MCM #6 Comments: POLLUTANT CONTROL MEASURES (PCMs) Indicate the status of implementing PCMS in Appendices A, B and/or C by completing the table below. Skip this section if PCMS are not applicable. Task Storm Sewershed Map(s) Source Inventory Investigation of Suspected Sources Ordinance/SOP for Controlling Animal Wastes PCM Comments: Date Completed Attached Anticipated Completion Date D D POLLUTANT REDUCTION PLANS (PRPs). AND TMDL PLANS 1. Complete this section if the development and submission of a PRP and/or TMDL Plan was required as an attachment to the latest NOI or application or was required by the permit, regardless of whether DEP has approved the plan(s). Submission Date 3/7/2018 DEP Approval Date 3/19/2018 Type of Plan Surface Waters Addressed by Plan Chesapeake Bay PRP (Appendix D) Impaired Waters PRP (Appendix E) TMDL Plan (Appendix F) Combined Chesapeake Bay Impaired Waters PRP Combined PRP/TMDL Plan Joint Plan Participants: Chesapeake Bay Pigeon Creek Chesapeake Bay, Joint Plan (ifc checked, list the name oft the MS4 group or names of all entities participating in thej joint plan below) -13- 3800-FM-BCW0491 9/2017 Annual MS4 Status Report 2. Identify the pollutants of concern and pollutant load reduction requirements under the permit (see instructions). Type of Plan TSS Load Reduction (Ibs/yr) 47,842.2 TP Load Reduction (Ibs/yr) 829.7 TNI Load Reduction (Ibs/yr) Chesapeake Bay PRP (Appendix D) Impaired Waters PRP (Appendix E) TMDL Plan (Appendix F) Combined Chesapeake Bay Impaired Waters PRP Combined PRP/TMDL Plan 3. Date Final Report Demonstrating Achievement of Pollutant Load Reductions Due: September 15, 2022 4. Have any modifications toi the plan(s) occurred since DEP approval? If Yes to #4, was the updated plan(s) submitted to DEP? If Yes to #4, describe the plan modifications. Yes R No Yes No If Yes to #4, did you comply with the public participation requirements of the applicable appendix? Yes No 5. Summary of progress achieved during reporting period. PRP is being revised as original stream sections proposed to be restored have since been deemed inellgible/impractical. After a site visit with DEP on 9/26/23, the Borough is likely to immediately restore a 155' section of stream thati is believed to be eligible for this credit. Other sections are being explored and the Borough plans on being proactive in achieving the prescribed load reduction. 6. Anticipated activities for next reporting period. Restore a 155' section of Pigeon Creek at Richardson Park. Locate other areas where restoration can occur. PRP/TMDL Plan Comments: 14- - D D D D - 3800-FM-BCW0491 9/2017 Annual MS4 Status Report CERTIFICATION For PAG-13 Permittees: have read the latest PAG-13 General Permit issued continues tol be eligible for coverage undert the PAG-13 General Permita and they by DEP and agree and certify that (1) the permittee that permit, including any modifications thereto. understand that ifIdo (2) permittee will continue to comply with the conditions of Pemmit, I will apply for an individual permit within 90 days of publication not of agree the to the terms and conditions of the PAG-13 General construction needed to comply with the General Permit requirements shall be General Permit. Lalso acknowledge that any facility system designed to assure that qualified personnel properly gathered and evaluated the information supervision in accordance with a submitted is, to the best of my knowledge and belief, true, accurate, and complete. lam for aware gathering that the information, the information submitting false information, including the possibility off fine and imprisonment for knowing violations. See there are significant penalties for with operative laws and regulations. designed, built, operated, and maintained in accordance For AlI Permittees: certify under penalty of law that this report was prepared under my direction or the person or persons who manage the system, or those persons directly responsible submitted. Based on my inquiry of 18 Pa. C.S. S 4904 (relating to unswom faisification). Stawly Glawask. Name of Responsible Official 724-239-2112 Telephone No. KA 9az/as Date 16-