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VIRGINIA DEPARTMENT OF ENVIRONMENTAL QUALITY - AIR PERMITS
LOCAL GOVERNING BODY CERTIFICATION FORMError! Reference source not found.Error! Reference source not
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Business Entity Name (same name on file with the Virginia SCC)
Registration Number:
Blue Ridge Equine Clinic, PLC
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Applicant's Name:
Name of Contact Person at the site:
Steve Trostle, DVM
Steve Trostle DVM
Applicant's Mailing address:
Contact Person Telephone Number:
434-973-7947
4510 Mockernut Lane
Trostle@blueridgeequine.com
Earlysville, VA 22936
Facility location (also attach map):
4510 Mockernut Lane
Earlysville, VA 22936
Facility type, and list of activities to be conducted:
Veterinary Clinic/Hospital - Equine
The applicant is in the process of completing an application for an air pollution control permit from the Virginia
Department of Environmental Quality. In accordance with § 10.1-1321.1. Title 10.1, Code of Virginia (1950), as
amended, before such a permit application can be considered complete, the applicant must obtain a certification from
the governing body of the county, city or town in which the facility is to be located that the location and operation of the
facility are consistent with all applicable ordinances adopted pursuant to Chapter 22 (§§ 15.2-2200 et seq.) of Title
15.2. The undersigned requests that an authorized representative of the local governing body sign the certification
below.
Applicant's '�^
signature:
Date:
The undersigned ocal government representative certifies to the consistency of the proposed location and
operation of the facility described above with all applicable local ordinances adopted pursuant to Chapter 22 (§§15.2-
2200 et seq.) of Title 15.2. of the Code of Virginia (1950) as amended, as follows. -
(Check one block)
The proposed facility is fully consistent with all applicable local ordinances.
The facility is inconsistent
proposed with applicable local ordinances; see attached information.
Signature of
Date.-
authorized
government
representative: "Wy OF 67r1f�2C.e+�
Type or ��IL7- �f�G��'4'
Title: /.�1� �Dr�7ii✓�S"7�2s?To�G
print name:
County, city or town:
Form 7 — December 19, 2018 Page 1