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PERMITTEE NAME/AODRE55 (/ndi4 srWryNa./7,eca,la UDID...np
<br />NAME _.. ..' - -- _' .. ., ..- .
<br />ADDRESS „ T ` ,:i L y ? ) ' .T r, ".~ y .._ .: t, r. •1 ,'
<br />r. ''910, /:~._-. r. i _. ~ .:
<br />FACILITY
<br />LOCATION
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<br />NATIONAL POLLUTANT DISCHMOE ELIMINATION SYSTEM INPOES)
<br />DISCNARGE MONfTORINO REPORT IOMRI
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<br />PERMIT NUMBER OISCNAROE NUMBER
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<br />YEAR MO DAY YEAR MO DAY
<br />FROM _ 'J TO °lt r.
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<br />T -~, OMB•No ~ 2040-000~
<br />Approval expires OS-31.98
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<br />PARAMETER ~ !3 brd Onlrl QUANTITY OR LOADING !1 brd On/yl QUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE
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<br />/32-37/ EX
<br />ANALYSIS TYPE
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<br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I cltan Fr UNDER PENN.TV of uw TNAT I NAVE PERSONN,Lr ExAMINEO AND TELEPHONE DATE
<br /> AM FA MILINi WITN THE INFO RMATION SUBMITTED HEREIN; AND BASED ON
<br /> MY INQUIRY OF TNOSE INDINDUALS IMMEDIATELY RESPONSIBLE FOR
<br />
<br />Richard MfIIS
<br />OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS _
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<br />~ TRUE. ACCURATE AND COMRETE. I AM AWARE TNAT TNERE ARE
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<br />--~ 3320-1 (08.95) Previous editions may be used. (REPLACES EPA FORM TAO WNICN MAY NOT BE USED.) ~ ~ ~ 7 ~ / ~ ~, f 11 ~ 7 _.1 r ~ „ PAGE _ Of i
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