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PERMITTEE NAME/ADDRESS II.,Ar T.,,eq r....., 1..; ,,,,.,. ,r r,p„.,a,
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<br />NATiONK POLLUTANT DISCHMGE E1IMMIATIOM SYSTEM /INPOfS)
<br />DISCHARGE MONRORINO REPORT lOMR1
<br />11-l81 17-191 FIT V,'1R
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<br />PERMIT NUMBER DISCNMGE NUMBER f. _ F i "~ ~ 1.
<br />Form Approved.
<br />OMB No. 2040-0004
<br />Approve! expires OS-31-98
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<br />NAME/TRLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENIV.TY OF LAW THAT I HAVE PERBOMALLr E%AMINED MD
<br />AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE
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<br />l(/ ~CI'1~I~.f TdY INOUMIY OF .?NOSE -INDIVIDUALS IMMEDIATELY flESPONSBLE. f0R
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRsl~rancs el/ sftschmsnfs hers)
<br />TSS G TOTAL ZP')N LI!'I-TTi~.4it,L 9E VIIIYEDF A9D SCTTLEAALE 40LT65 LII!IT APPLTFO -OP <=InTPs?ItHo PRP.CIP F'1~ItT-
<br />L'f AURDBR Of PROOF RPJUIRF9EtITS KINDER I.A.3. PLHNIlTP.1, COST TIEP ALL PPASOM4AL~ CP,R4ARh^ TO RP,DOr•s
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<br />EPA Form 33 211-1 10 8-951 Previous IEions mey be us 1 LAC F WHI A T '1 qDp D 1 /~ ~ 0 4 21-I D ? A PAGE ~ OF ~
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