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<br />DISCHARGE MONITORING REPORT (OMRI OMB NO. 2040-0004
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<br />COf%U,~.7154 003 A (SUbR NY)
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<br />NAME(TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT 1 HAVE PERSONALLY EXAMINED AND
<br />AM FAMILIAR WRH THE INFORMATION SUBMITTED HEREIN; AND BASED ON MV TELEPHONE DATE
<br />Richard MI Its INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING
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<br />97Q-870-Z71Z
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<br />. ~1i ~ PENALTIES FOR SUBMITTING FALSE INFORMATION. INCLUDING THE
<br />POSSIBILITY OF FINE AND IMPRISONMENT SEE 1B U.S.C. 4 1001 AND 33 U.S.C.
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<br />SIGNATURE OF PRINCIPAL EXECUTIVE
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<br />I COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
<br />AL1r~RllA';? LI~IT_S FL'R TSS, ZHOH & SET'PLEA9LF. SOLIDS (LOC TO') APPLY ONLY I° <= 1G-Y+), :U-tlF Pk;;CI° EVEN;
<br />CLiIF1ED. SEL•' I.A. L, FG 1lI, FOR dUkO~;N Oi PAOU7 FE4UIF£HENTS. OIL d i,.tcAS°-t' t:..,...,~. F/ CC ?.
<br />^4'IiRTY vTHVI TNG F. Q4 DfTkTTNC TNCTArIC'^T/lYC-A(IITT YTITY R/. r
<br />EPA Form 3320.1 (08-95) Previous editions may not be used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.) C V 0 j 7 / 0 U C 4 . ` - L' • C I PAGE L OF
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