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<br />NATIONAL POLLUTMT DISCHMOE ELIMINATION SYSTFM INPDESI
<br />DISCHARGE MONITORING REPORT lOMRI
<br />1-161 I7-191
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<br />PERMIT NUMBER DISCNMGE NUMBFA
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ~ 7 ^3 JL TO ~~ Ill ~1
<br />12611/ l21-23/ !1415/ /1627/ /28-19/ 13P3F/
<br />Form Approved.
<br />~.y.. r ,, ,~., ., _ T.~OMBlNo.,2040-0004.-.
<br />/ _ „ ~, ^ r, 1 I Approve{ expires OS-31-98
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<br />132-371
<br />MALrsls TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !s]-sal (5/-581 1e9-701
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<br />LFFLU3XT :,~: _ .'T,r11 REQUIREMENT [.ftiST '!AY N°=0 #:~•-•-
<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF L
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<br />THE POSSIeILITV OF RNE MD IMPRISONMENT. SEE is U.S.C. f toot MD 77 SIGNATURE OF PRINCIPAL E%ECUTNE 97U R79-271 ~ 4 LI3 g9
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<br />EPA Form 3320.1 108-951 Pretnoue edlttone may bs used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.1 t` n ~ i ~ /O R ^ + ^ 7-, n l / PAGE t OF
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