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PERMITTEE NAME/ADDRESS /Gdi4 F«Wry NanWL«suen dDl~r.np
<br />NAME ' Y n .. .~ ... ... ,. ~ r . .. ~ ..
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<br />ADDRESS •' T . ~ ~. a ' ~ • + " 'I
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<br />FACILITY
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<br />NATIONAL POLLUTANT DISCXMOE EUMINATON SYSTEM /NPDESJ
<br />DISCHARGE MONITORING REPORT (DMRI
<br />1-151 117-191
<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAV YEAR MO DAV
<br />FROM ? ? '' i ~ TO "'~ '1 ~ • t
<br />rJn-J fl !JZ-Z31 /1(-J5l /76-I7! 115-19/ 130-311
<br />Form Approved.
<br />_~ ~ E F. , ~. ~ ~ ~ ONIB~No..2040-0004
<br />l,. ... _ ? APProvel exP,lls0~31-98~
<br />NOTE: Rud imtructlam bsfon compMtinb thb form. ~{ r
<br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !4 Grd Onhl QUANTITY OR CONCENTRATION Np, FREDUENCr SAMPLE
<br /> 115-591 154511 !38451 1e5-63 !51-51 EX DF TYPE
<br />137.371
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<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ls7~5.T1 !54581 159-)Ol
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<br />NAMERnlE PRINCIPAL EXECUTNE OFFICER I CERTI
<br />AM FA FY UNDER PENALTY OF
<br />MILIM WITH THE INFO LAW THAT I HAVE PERSONALLY EXAMINED µD
<br />RMATION SUBMITTED HEREIN; µ0 BASED ON /
<br />/ TELEPHONE DATE
<br /> MY INQUIRY OF THOSE INDIyIDUALS IMMEDIATELY RESPONSIBLE FOR ~
<br />t OBTNNING TXE INFORMATION, I BELIEVE THE SUBMITTED INFORMATON IS
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<br />TIES FOR SUBMITTING FALSE INFORMATION
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<br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS lRelerence en etrscnmsnrs Hero/
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<br />EPA Form 3320-1 108-961 Previous editions mey be used. (REPLACES EPA FORM T40 WHICH MAV NOT BE USED,1 ~ ^ ~ ~ :! / ~ o n ~ ~ _! _ t , .i I PAGE OF
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