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["INSTRUCTIONS"]
["·","Input the applicable authorization number"]
["·","Select the authorization type from the drop down box (ie permit, approval, registration)"]
["·","Record the legal authorization holder name"]
["·","Record the name of the person authorized to complete the form (i.e. anyone authorized to act on behalf of the authorization holder, for example: environmental manager, technician, etc)"]
["·","Record the date the document was signed "]
["·","Identify each clause in your authorization that has a requirement or limit"]
["·","Record each identified authorization clause number under the heading “AUTHORIZATION CLAUSE NUMBER” "]
["·","Record each identified authorization clause description under the heading “AUTHORIZATION CLAUSE DESCRIPTION”.  This may be a summary, or cut and paste from the authorization document."]
["·","Indicate whether or not the permittee has met the requirements of each authorization clause by selecting either “Yes, \"No” or “ND” (not determined) under the heading “COMPLIANT?”."]
["·","In the \"RATIONALE FOR YOUR COMPLIANCE DETERMINATION\" column, indicate why the determination of “Yes, \"No” or “ND” (not determined) was arrived at. For example, if your response was...:\n                 * YES - \"All lab results met the permit requirements\"\n                 * NO - \"Lab results did not meet the permit requirements on Nov 1 and Dec 15...\"\n                 * ND (not determined) - \"Discharge samples not collected as there was no discharge\"                  \n"]
["·","In the \"LOCATION OF SUPPORTING INFORMATION IN ANNUAL REPORT\" column, provide the location (i.e. page number, table, figure, appendix) in the annual report for the information that your compliance determination is based on.  If the information is not in the annual report please provide details of where it can be found."]
["·","If required, add lines by clicking the \"Click to add lines to the table\"  button"]
["·","Have the authorized person sign in the \"AUTHORIZED PERSON SIGNATURE\" field located at the top of the form"]
["·","Have an authorized person initial and date the footer of each page"]
["DEFINITIONS"]
["Authorization Number",null,"The authorization number for your permit, approval, registration, etc.  This information can found on page one of your authorization document."]
["Legal Authorization Holder Name",null,"The legally designated party that the authorization has been issued to (i.e. permit or approval holder, registrant)  This information can found on page one of your authorization document."]
["Authorized Person",null,"The person granted authority by the authorization holder to attest to the correctness of the information presented.  "]

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[null,"Annual Compliance Status Form"]
[]
["AUTHORIZATION NUMBER:"]
["AUTHORIZATION TYPE:"]
["LEGAL AUTHORIZATION HOLDER NAME:"]
["PERIOD OF COMPLIANCE STATUS ASSESSMENT:",null,null,"YYYY-MM-DD to YYYY-MM-DD"]
[]
[]
[null,null,"AUTHORIZED PERSON NAME:"]
[null,null,"AUTHORIZED PERSON SIGNATURE:"]
[null,null,"SIGNATURE DATE:"]
["I understand that it is an offense to mislead a government official, and I declare that all of the information presented is accurate and true.  \nI have been given the authority by the authorization holder to sign this form."]
[]
[]
["AUTHORIZATION CLAUSE NUMBER","AUTHORIZATION CLAUSE DESCRIPTION","COMPLIANT? (Yes/No/ND)","RATIONALE FOR YOUR COMPLIANCE DETERMINATION","LOCATION OF SUPPORTING INFORMATION IN ANNUAL REPORT"]
[null,null,"Yes"]

{"sheet":"Form Data","index":2,"n_rows":5,"n_cols":3,"rows_kept":5,"cut":false,"hidden":false,"merged":[]}
["Authorization Type",null,"Compliance Status"]
["Permit",null,"Yes"]
["Approval",null,"No"]
["Registration",null,"ND"]
["Operational Certificate"]