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PERMITTEE NAME/ADDRESS O. L4 Frrtlry Na./L«enow IJDr)JinrwO
<br />NAME ~. Y n .. ~, r 1 • ': L ".., -~. `' .
<br />ADDRESS !f i.~i.:-. FEC ~~ ~~~"„'E ..-vwr a: P[
<br />FACILITY
<br />LOCATION
<br />NATIONAL POLLVTANT DI6CHMGE EUMINATON fiY6TEM INPOESI
<br />DISCHARGE MONITORING gEPORT IOMR)
<br />7-161 I7-191
<br />PERMIT NUMBER DISCNMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAV YEAR MO DAV
<br />FROM '+ .; TO ~~ ~' ' I 1
<br />110.111 172-731 /14751 /76771 lI8-19/ !363/1
<br />Form Approved.
<br />-_•': ~ ~, -. •~OMB,No.t2040-0004:•v
<br />r Approval expiTee 05-31-98
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<br />'NOTE: Resd inetrucUone befor c -gtpletinq this form.
<br />PARAMETER !3 Grd Onlvl QUANTITY OR LOADING !1 Grd Ontyl QUANTITY OR CONCENTRATION NG FREOUENCV SAMPLE
<br /> !66531 154-e 11 13BJ51 4653 1546'/1 EX OF T1,PE
<br />l37-371 ANALV516
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 161-s]! /54651 159-]Ol
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER AM
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<br />eIASE ~ TELEPHONE DATE
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<br />environmental i ~Dnager TRUE, ACCURATE AND COMRETE. I AM AWARE THAT THERE IUIE
<br />SIGNIFICANT PENALTIES FOR SUBMITTING FILL6E INF011MATION
<br />INCLUDING
<br />970) E7O-271 Z
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<br />THE PO651BILITV OF RNE AND IMPRISONMENT. SEE 18 U.6.C. 11001 AND ]3 -
<br />SIDNATURE OF PRINCIPAL EXECUTfVE
<br /> U.S.C. E 131 e. rFV WM. uM~r IMF mnm. nrr r+chm A+.. ri ro 710.000 AREA
<br />TYPED OR PRINTED YIC G.rIWYAlI11{`ePn'ADMMrarMrwwr enweels rNl6 t'eerAl OFFICER OR AUTHORIZED AOENT CODE NUMBER YEAR MO Dqy
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRsterencs ell sttechments here)
<br />'L.'::%i4ATl? LL•'1T°~ S'l:~ Tzir _"Jh' ~'CTL°~ALF' ;ll,r!1~ (I D- rTE) AnnTV ny?v rr !- ~r~_v7e ~: ~I_~:: aoc r`r_p ;n?.. +.
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<br />Iry' cf .nr* Orn -~arv r.cmv•r~ rn.~ _cnn a.. n•rc ~/
<br />EPA Form 3320-1 108.96) 'Prenous ediuons may be used. (REPLACES EPA FORM T~0 WHICH MAY NOT 8E USED.) ~ ., „ , ., / ,t , ~,, , ~ _ { ., -t „ PAGE I OF
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