Laserfiche WebLink
Gam Appro.ao <br />FER MITICF NAMEfADORE55 ~wdLldryNr'l.v r.,. y;wn~...., vn, -....; r,., ~.'. 'ti~r:a.'r Mal r~:4 ... •.,>!: :.. ;'!u !tif'C•E.Si OME lb 200D-0ODE <br />NAME DISC NAflf,E MCNRORIN RlPnAI i~:!.+. ~; _ -' <br />AOORESS <br />PERMIT NVMRER bYn M°E NwlER - PI ~ A L " • <br />MONITORING PERfOD J <br />FAI:IIfTY Y MU DA YEAR MO D Y <br />>' <br />LOIL.ATx)N FROM TO - <br />NOTE: Mid kwtEVCdorw Mfa~ comvhtlnQ Efih form. <br /> <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. nEl°vERCr <br />OF SAMPLE <br /> Ex µKVgS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMVM VNfTS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMR ~ c ~, ... .. t ~ .. .... <br />_ - REQUIREMENT !S R y is 1.U E. _ - <br /> SAMPLE <br /> MEASUREMENT <br /> PERNwT - -_ ~ ,.... .. , <br />- _ REQUIREMENT !`.6 Y ~ __. <br /> SAMPLE <br />MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> <br />-_ <br /> SAMPLE - <br /> MCASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PEA MIT <br />AEQVIREMEM <br /> SAInvLE <br />MEASVREME NT <br /> PERMIT <br /> REQUIREMENT __ <br /> SAMPLE <br />MEASUREMENT <br /> PCRMIT <br />REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECVTTVE OFFlCER ~m:'r,. ,rtit•J1.. qn V <br />E .w btenewla M.nrba <br />..+ <br />... <br />..un <br />n eM. ~... <br />. <br />.l. <br />d <br />1 <br />M TEIEPMONE GATE <br /> wer <br />.r <br />y <br />.. <br />a <br />Ew <br />...v..e+.. <br />.. T~ a...la... ar• <br />o <br /> .sv.. n......u,+.a rw.w rr~r Mr..r ..wn. u. lwrw.e.oan - - <br />_ <br />. ~ ebnd~~wl ~~..f ee wl•M.ery.l G. rn...r r.ole.M ew.f. IM .y.l..l. ~-- - .. <br />- <br />~ <br /> ml1.e.. revue b...nr ...W+dM. 4w IWMryMIwrwWw, MIMnnWl+n J• <br /> .... M. iA.•• \wtil <br />. W MW <br />I.w <br />r <br />vrM. <br />.wp .wry..1. <br />w <br />i <br />M M <br />1 .. •~ • <br /> E <br />w <br />. <br />I <br />. <br />. <br />a <br />. <br />. <br />1 ~ <br />A <br />F <br />f C1ITIVE <br /> ... u.~ ~..~ ... dpn.ar !eWbn hr..b..ElonE nb. wa...ea.e. <br />' <br />' <br />~ IMNATLRl O! <br />IIpIC <br />At <br />X <br />OrE1CER OR AUfMOR12E0 AOfM ~ A NVNBEP YEAR MO OAV <br />TYPED OR PRWTED .+ <br />xr1~.E ~n.pee+ut. of n....e ..yn ,....l <br />.m.ly .w+wew. <br />COMMENTS ANO EXpIANATION OF ANV VIOLATIONS lRd/rdnc~ d dN~cAmmb AwAI <br />Y~ .. <br />CPA Form 1720-1 (Rm. ]'99) Prov~ou~ eanu.s ..uY a u+~. - • / •~l3 n:a S-patt form PAGE OF <br />