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PERMITTEE NAMEIADDRE85 !lMr4 F•rWryNw/luanm t/Dlpawp
<br />NAME L:Y^ '. [5"" [L '~[. -,a
<br />`ten ADDRESb ~' ~ ~ _ : 1. F L E l ~ ~ ' a .. c' r
<br />FACILITY
<br />LOCATION
<br />NATIONAL POLLUTANT OISCHAROE ELIMINATION SYSTEM /NPDES)
<br />DISCHARGE MONITORING REPORT IDMRI
<br />!7- 161 17- 191
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ~ "1 '13 ~ TO '~ ~ :1 3 T 1.
<br />174711 171-331 !74151 176-771 118-791 136311
<br />A.
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<br />Form Approved.
<br />w n ONIBINon 2040-0004.- ..
<br />Approve expires OS-31-98
<br />A NOTE: Reed Inetnletlone before eompletlnp this loan.
<br />PARAMETER I3 Grd Onlyl QUANTITY OR LOADING /I Grd On/yl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
<br /> (06531 15461 I3B-151 !4653 !5451 EX ~
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<br />l37-371 95
<br />ANI
<br />LL TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS rt7-sal 164681 169-701
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<br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I CERTI FY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND TELEPHONE DATE
<br /> AM FA MILIM WITN THE INFORMATION SUBMITTED HEREIN; AND BASED ON /~
<br />tt
<br />Richard 1~1~~3 MY INQUIRY OF THDSE INDINDUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTAINING THE INFORMATION, I BELIEVE TXE SUBMITTED INFORMATION IS '
<br />~^~ ~ ' /~
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<br />~' TRUE, ACCUMTE AND COMPLETE. I AM AWARE THAT THERE ARE
<br />SIGNIFCANT PENALTIES FOP SUBMITTING FALSE INFORMATON
<br />INCLUDING (
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<br />ara er
<br />nvlrolTrrxanta!
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<br /> THE POSSIBILITY OF RNE AND IMPWSONMENT. SEE 18 U.S.C. f 1001 AND SS BIONATURE OF PRINCIPAL EXECUTNE O 7 1{ FI qQ
<br /> U.S.C. 1 1 ] t e. IANWtla uM•r Fbr corona rllaY YeN.da rawa IP ro r IO,OOD
<br />TYPED OR PRINTED aM av muwwnirpT'arrwlr aabnaaan smmNa •rW 6Y•ral OFFICER OR AUTHORIZED AGENT LODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY vIOLATIDNb IRererenes e6 etrocnments oars/
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<br />EPA Form 3320-1 (OB-95) (REPLACES EPA FORM TAO WHICH MAY NOT BE UbED.)
<br />PreNOUe editions may be used. ~ ,. ~ -1 t{ / n ^ ^ " ~'7 - T f) -I'1 ~ PAGE OF
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