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<br />NATIONAL POLLUTANT OISCHMOE ELMIMATION SYSTEM (NPDESI
<br />DISCHARGE MONITORING REPORT (OMRI
<br />l1-I5I l17-191
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<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM I '• l` :' TO 4" i
<br />!16171 121-T31 !14151 !16171 118-191 !36311
<br />Farm Approved.
<br />„T .. ~ _ ,~., . ^ ~~OMBIEIo~2040-0004- ;
<br />I,. ., ~ ~ F ~ APProvel a PiSee OS-31-98
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<br /> !16531 !54511 l38-451 !0653 !54571 OF
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<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS Isz-s9l !54581 (59-)OI
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTI
<br />AM FA FY UNDER PENKTY OF LAW TNAT I HAVE PERSONALLY E%AMINEO MD
<br />MILIM YATN THE INFORMATION SUBMITTED HEflEIN; MD eA5E0 ON
<br />~ TELEPHONE DATE
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<br />
<br />Richard Mills MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTNNING THE INF01U/ATION, 1 BELIEVE THE SUBMITTED INFORMATION IS /
<br />
<br />
<br />tnvironmenfal Manager
<br />TRUE. ACCURATE MD COMPLETE. I AM AWME THAT THERE ME
<br />SIGMIFICMT PENALTIES FOR SUBMITTING FILLSE INFORMATION
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<br />THE POSSIBILITY OF FINE MD IMPRISONMENT. SEE is U.S.C. 1 1001 MD 30 BIONATURE OF PIIINCIPAL EXECUTNE
<br /> U.S.C. 1 t 3t s. lPUMId•• utWr tMS mwro• eI•Y NtcMIU• Bn•• w ro F 10,000 AREA
<br />TYPED OR PRINTED Ara or ntulmMn MArimrent elMiwwnemonsM rtds Y••Ia/ OFFICER OR AUTHORIIEO AGENT CODE NUMBER YEAR MO DAy
<br />COMMENTS AND EXPLANATION OF ANY VIULAIIUN, (/FBFersnce s!/ettscnmenf9 ~a~~l
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<br />EPA Form 3320-1 108-951 ^Prevlous edmons may be used. (REPLACES EPA FORM T+30 WXICH MAY NOT BE USED.) ~ n ~ , ~ ~",I ~~.T _ , ,~ .t , PAGE T OF
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