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PERMITTEE NAME/ADDRESS B•a,a. Fr,HryNa/Loe•n•n r/od4.ov)
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<br />NATIONAL POLLUTANT DISLH.410E ELIMINAPON SYSTEM (NPOESI Form Approved.
<br />DISCHARGE MONITORING REPORT lOMRI t ., , „., ,. O B 0..2040-0004- .
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<br />YEAR MO DAY YEAR MO DAY _
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<br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING 14 Grd Onlyl QUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE
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<br />131-371 EX
<br />ANALYSIS TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 167-691 /50-581 169-701
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PFNAITY OF LAW THAT I HAVE PERSONALLY ExAMINED AND
<br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND EASED ON ~ TELEPHONE DATE
<br /> MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR /-
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