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<br />" Form Approved.
<br />NATIONAL POLLIRMT OISCNMOE FUMINAl10N SYSTEM NPDESJ ~ OMB No. 2040.0004
<br />DISCHARGE MON170RIN0 REPORT (O~RI {?y k U
<br />PERMIT NUMBER DISCHMOE NUMBER " '- C"S LS ?~~, - Yzu~l, :a ~
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<br />FROM YEA .O DA TO Y ~ MO, DAY :;;,;r;•r iC Sr !7 ~~C t': >1rGie ~,~) "M"~' ~.
<br />NOTE: Reed Inetluetlom belare oompletln0 thb loan. ". ~~
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<br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER ' ""'9 """" °'""O °"'"'""'"° °°'""1e1X'"° "' •"'r""""° "`^
<br />prtpertd aMa mT direellon w mper.4lan In •nord.nce Mlh . rfrlem deNEmtl
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<br />dW y ipulrf NtlK person a person. who mange IM eritrm, r
<br />r-~ ar rhoee penom direrly roponYbNlor plhednE the lnfemuelan, the lnlamellon.. ~°/
<br />~/?//. (yyrr;T ~ wbMrlMb,mNe Eat almT Enawkdp eM peSel, eru<.w vnee..ndmmplne.
<br />l em ennrt Ihal inert ert NlNllrem penNlb far nEmlltlnp hhe mtarmillon, BIONATURE OF MIINCIFAL EXECUTNE
<br />TYPED OR PRWTED IMWInE the podMOryolnneeM lmpdwnmenl for EnowlnE dNetlo~n OFFICER OR AUTNOR12E0 AGENT "
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRefirencs aN sttechmenb herd
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<br />DATE
<br />~IC~x-~3~a1 a/ I ~z- 12,E
<br />E I NUMBER ~ NEAR MO DAY
<br />:~iA i;E{°.~u2'L.~. ~° ~G2liiS~~iL~
<br />EPA Form 3320.1 (Rev. 3199) Previous editions may 6e used. ;); ~ A?~ 4 °/ ~lt~"f$y~A"~~~'©~
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