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<br />PERRjIITTEE NAME/ADDRESS (Inchde Faclliry NamdLxalion yDij(erenq
<br />NAME CT^EU'.? +ArDA VAT,L'T 'JAL ~OHP.
<br />ADDRESS!:i"•%'S L, 2;3 SOLI^Y, S E-KNAR PK
<br />a 5170 FAST '1fNoPAL .!2^L°
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<br />FACILfTY
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<br />NATIONAL POLLUTANT DISCHARGE ELJMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMRI
<br />(216) (1I- 9)
<br />~J77271 ;i ..^,n~ 11
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ' )% 1 TO ~' ~~
<br />l2P211 (22-23) (2025) (2&27) (28-291 (3p31)
<br />Form Approved.
<br />Y ~ ~ ~ P OMB No. 2040-0004
<br />Approval expires 05-31-98
<br />(i7RP NF)
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<br />NAME/TITLE PRINCIPAL EXECUTVE OFFICER ICERTIFY UNDER PENALTY OF LAW THAT I HAVE PERS
<br />TTED HER ONALLY E%AIAINED AND
<br />AND BASED ON MY
<br />EIN
<br />' TELEPHONE DATE
<br /> AM FAMILIAR WRM THE INFORM
<br />INQUIRY OF THOSE INDNIDUAL
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<br />E+lvlro~mental `,°.anaUer PENALTIES FOR SUBMDIIN
<br />POSSIBILffY OF FINE AND IMPR G FALSE INFORMATION, INCLUDING THE
<br />ISONMENT. SEE 1e U.S.C. § loot AND 33 U.S.C. SIGNATURE OF PRINCIPAL EXECUTIVE Q .!
<br />
<br />TYPED OR PRINTED 5 1319. (Perexles urMer Nese sleruMS may include Ilrres up ro 310,000 end a
<br />rreximum ~mpdsonmerx or beMeen6nxn0e entl6ye9rJ.) OFFICER OR AUTHORIZED AGENT
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence ell attachments here)
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<br />EPA Form 3320-1 (08.95) Previous editlons may not be used ~ (REPLACES EPA FORM T~0 WHICH MAY NO7 8E USED.) OOl 5 0 / 5 4 ~ 41 ~-1 S 7 4 PAGE ~ OF
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