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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MPDES) FOfm ApprOVed.
<br />DISCHARGE MONITORING REPORT (DMR; OMB No. 2040.0064
<br />Approval expires OS31-98
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF
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<br />EPA Form 3320.1 (OB-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF
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