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<br />NAME T 1 :~ .-' ~ - .. ~ -
<br />ADDRESS T k d • ; r .
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<br />FACILITY
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<br />NAryDNALSCHARCE MONITORNN6 REPORT OMRIPDfSI
<br />D 1-761 17-191
<br />COOJ32115 CO_ A
<br />PERMIT NUMBER DISLHMGE NVMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM TO -'
<br />/20.111 l22-131 /14761 /26271 /2B-291 130-311
<br />,/Form Appro~lved.
<br />FOND MI TO CAST =Q,~!+la,?9~,~Fr1
<br />(5 C F P D k) APProvelle><p~Iaq 05-31-98
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<br />PARAMETER l3 Ard Ontyl QUANTITY OR LOADING - /1 Grd On/yl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE
<br /> !16531 /545/1 13B~Sf !1653 (5461) QF
<br />/3I-371 EX
<br />MALY519 TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 1e2-em (54581 159-701
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<br /> MEASUREMENT
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<br />NAME/I1TLE PRINCIPAL EXECUTNE OFFICER I CERTI
<br />AM FA FY UNDER PENALTY OF lAW THAT I HAVE PERSO
<br />MIIIM WITi 7NE RiFORMAT10N SUBMITTED H NALLY E%AMINED MD
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<br />MD BASED ON TELEPHONE DATE
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<br />MY INQUIRY OF THOSE INDINOUALS IMMEDIATELY RESPONSIBLE FOR
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<br />IYr Gordon Peters OBTAINING THE INFORMA710N, I BFIIEVE THE SUBMITTED INFOMIATION IS
<br />TRUE. ACCURATE MO COM0.ETE. I AM AWME THAT THERE ME
<br />SIONIFICMT PENKi1EB FOR BUBMITTING FALSE INFORMATION
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<br />CODE NUMBER
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