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<br />NATIONAL POLLUTANT DISCHMOE ELIMINADON SYSTEM INPDE$)
<br />DISCHARGE MONITORING REPORT (DMRI
<br />!T-I61 l17-191
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<br />PERMIT NUMBER DISCHAIIGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM i'1 ,,r .. TO -' ' '1 ; "
<br />176711 !TT-T 31 !74151 !T6-T7/ !Te-191 !36311
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<br />Form Approved. ftM
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<br />Approval axpirap OS-31-98 'r
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<br />NOTE: Read Irutructloru before o pletin0 thu form.
<br />PARAMETER I3 Card Onlyl QUANTITY OR LOADING I4 Ord On/yl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
<br /> I<6531 I5I-61 I38O51 /4653 !5461/ EX DF
<br />137-371
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<br />UNITS
<br />MINIMUM
<br />AVERAGE
<br />MAXIMUM
<br />UNITS
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<br />154681 TYPE
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<br />169-701
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<br />( -' ~ ~~ MEASUREMENT
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<br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO
<br />AM FAMILIAR WITH THE INFORMATION SUBMITTED H NALLY E%AMINED AND
<br />EREIN; AND BARED ON TELEPHONE DATE
<br /> MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
<br />
<br />Klcharcl
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<br />OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATON IS ~/~
<br />.. TRUE, ACCUMTE AND COMPLETE. I AM AWARE THAT THERE ARE i
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<br />CflvlrQ':c.~r.t-1 I ~F]f1R _^Br SIGNIRCAHT PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING D7 C_ ~7 (I_'l ltn 3 ~u i,D
<br /> THE POSSIBILITY OF RNE AND IMPRISONMENT. SEE 1B U.S.C. E 1001 AND ]3
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<br />COMMENTS AND EXPLANATION OF ANY VIOIa I TUNS lRerer~nca sn srrecnmanre Hare!
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<br />EPA Form 3320.7 108.961 Prevloue edlDOna may bs ueed. (REPLACES EPA FORM 7.40 WHICH MAY NOT BE USED.) „ PAGE
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