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<br />NATIONAL POLLUTMT DISCHMOE ELIMINATION bYBTEM INPDES) Form Approved.
<br />DISCHARGE MONITORING REPORT IDMR) .OMB No..2040-0004
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<br />FROM D~ ALL Ji TO ..~ Jo C. -.;:,. .. i)T .C~?..~..:'- Imo-. /_~~ `1 S~''
<br />' 1161/1 l11-131 114-151 116-171 118-191 136311 + NOTE: Reed Im[ruetlGM before completlnp thle Corm.
<br />PARAMETER l3 Ord On/yl QUANTITY OR LOADING /I Ord On/yl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
<br /> !46531 154-e/I (38-451 (4653 1546) GF
<br />(32-37) E% MALVSIS TYPE
<br /> AVERAGE MA%IMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS let-s]~ 154-581 159-701
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<br />NAME7TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED MD
<br />AM FAMILIM WITH THE INFORMATION SUBMITTEO HEREIN; MD BASED ON TELEPHONE DATE
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<br />/ MY INQUIRY OF THOBE INDINDUKS IMMEDIATELY RESPON9BLE FOR '
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<br />I OBTAINING THE INFORMATION, I BELIEVE THE BUBMITTED INFORMATION IS _
<br /> TRUE. ACCUMTE MD COM0.ETE. I AM AWME THAT TNERE ME i
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<br />SIGNIFfCMT PENALTIES FOR SUBMITTING FALSE INFORMATION
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<br />SIGNATURE OF PRINpPAI E7EEl:UTNE
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<br />GVMMCN IS ArvY [Ar~nnn nvlr t+r nrvT vlv~n.wrva lnsrerence en ermcnmems nere/
<br />EPA Form 3320-1 108-95) Previous editions mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.1 ~ ` ` _ _ 4 PAGE OF
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