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PERMTITEE NAME/ADDRESS (Inclade Facl/iry NamrJ[«anoa iJDi$erenq
<br />NAME rYpRUS (A'1PA YALL?'Y CJA.C CORP.
<br />ADDRESSMIN(!5 1,1:) i111J'r'j'. ` F:CK'AN PR
<br />9100 Pt15? "Ik=RAL CIP^LS
<br />ENGLcNJOD '0 9015ti
<br />FACILITY
<br />LOCATION
<br />A7TN: .°.OdNIS Y, R'rGLkY, ,FY!~:P.1L t1TNr
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) FDfm AppmVOd.
<br />DISCHARGE MONITORING REPORT (OMR~ OMB No. 2040-0004
<br />fz-16) pr- sl i
<br />~ ° T ~ ~ Approval e>~ires OS-31-98
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />R WRH THE INFORM LAW THAT I HAVE PERSO
<br />ATION SUBMITTED HER NALLY E7(AMINED AND
<br />AND BASED ON MY
<br />EIN TELEPHONE DATE
<br /> AM FAMILIA
<br />INQUIRY OF THOSE INDNIDUAL S IMMEDIATELY RESPON
<br />T
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<br />D IN ;
<br />SIBLE FOR OBTAINING
<br />FORMATION IS TRUE ~
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<br />
<br />Richard Ar~ills THE INFORMATION, I BELIEV
<br />ACCURATE AND COMPLETE. HE SUBMI
<br />TE
<br />E
<br />1 AM AWAKE THAT 7H ,
<br />ERE ME SIGNIFICAN7
<br />INCLUDIN
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<br />97D a7D-~~);
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<br />Cnvironr:ental ?.M1anager PENALTIES FOR BDBMITnN G FALSE INFORMATION,
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<br />AND 3
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<br /> POSSIBILftt OF FINE AND IMPR ISONMENT. SEE 1a U.S.C. 4 1001
<br />3 U.S.C.
<br />510
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<br />000
<br />M SIGNATURE OF PRINCIPAL EXECUTIVE
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<br />NUMBER
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reverence ell edacnmenrs here)
<br />ALTERNA'F~ LI9ITS PfIP. T;S, IRO° S SRrTLEA9LP. i1LIDS (LJ_ '0r) II^pL[ n"+L• Tv C= ID-°•+, "L_rr~ pocCiP °v?N°'
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<br />EPA Form 332x1 (08-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) 0 0 ~ ~ q ~ ~ ~ ~ It i ~ i , ~ r. PAGE •? OF
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