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<br />NATIONAL POLLUTANT DISCNMOE ELIMINATION SYSTEM (NPDES) Form Approved. <
<br />DISCHARGE MONITORING REPORT IDMRI ~ ~ / . _ .. O B.No~, 2040-0004•,
<br />IT-161 IE7-191 - .. I'Q I
<br />.') ;'? ~, l: ;~', 1 ,; . . (, - i• ~ ., ~ APProvei eXP,iroe 05-31-98•
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<br />MONITORING PERIOD '
<br />YEAR MO DAY YEAR MO DAY __
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<br />lT6T!/ !TT-131 ITb75/ !76771 !1B-T9l 136371 NOTE:• Read InetrucElom bNora completlnp this form.
<br />PARAMETER !J Grd Onlyl QUANTITY OR LOADING !~ Grd Onlyl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE
<br /> 146531 !545/1 I3B-15 !06531 !545/1 DF
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<br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I CERTI
<br />AM FA FY UNDER PENALTY OF UW THAT I HAVE PERSOMN.LY EXAMIN W AND
<br />MIUAA 1MTN iNE INFORMATION SUBMITTED HERON; AND BASED OFL'~ - --"-- I
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<br />1 TELEPHONE DATE
<br />~ichard ,~. .?ttn ~,on MY INQUIRY OF THOSE INOINDUALS IMMEDIATELY RESPONSIBLE FOP I
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<br />OBTNNING TXE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION ISM I
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<br />SCE IT •'3S(~°Tlt TRUE, ACCURATE AND COMPLETE. I AM AWME THAT THERE ARE ~~'pL(,','L ~ ~ "~~•
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<br />SIGNIFICAMT PENALTIES FOR SUBMITTING FN.SE INFORMATION
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<br />EPA Form 3320.1 (08.951 Previous editions may be used. (REPLACES EPA FORM 740 WHICH MAY NOT BE USED.) ., .. / , . PAGE 1 OF
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