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PERMTfTEE NAME/ADDRESS (Inc(ude Faciliry Name/Incmion ijDi$erenQ
<br />NAME CTPROS Ytro c•
<br />A VALL.. 'QAL C03P.
<br />ADDRESSAINc°, 1,2%3 iQIIT9e i P"EC'!AN P?
<br />9107 *~~^~ ~Tac~R11L CT^vLR
<br />FACILITY E4G~LEIiD07 C7 4p155
<br />LOCATION
<br />ATT": '7^?IiI; iT. [F',^.T.F!- ('e'~P971. ATHP
<br />NATONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCNARGE MONITORING REPORT (DMR;
<br />(2-16) (1]- B)
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<br /> PERMIT NUMBER DISCHARGE NUMBER
<br /> MONITORING PERIOD
<br /> YEAR MO DAY YEAR MO DAY
<br />FROM ~~ Q7 7 TO ^~~ Rl ?1
<br />(1621) (2223) (2425) (28-2]) (28-29) (30-31)
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<br />Form Approved.
<br />OMB No. 2040-0004
<br />" ` T ~' Approval expires OS31.9B
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<br />NAME/TiTLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSONALLY E](AMINED AND
<br />ATION SUBMITTED HEREIN; AND BASED ON MY TELEPHONE DATE
<br /> INQUIRY OF THOSE INDIVIDUAL S IMMEDIATELY RESPONSIBLE FOR OBTAINING ~
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<br />F E THE SUBMITTED INFORMATION IS TRUE,
<br />I AM AWAfiE THAT THERE ARE SIGNIFICAM
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell tTt~chments here)
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<br />EPA Form 3320.1 (OB-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF
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