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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Fortn Approved.
<br />DISCHARGE MONITORING REPORT (OMR~ OMB No. 2040-0004
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<br />NAME/fITLE PRINCIPAL EXECUTIVE OFFICER I CERTI
<br />AM FAM FY UNDER PENALTY OF
<br />ILIAR WITH THE INFORM LAW THAT I HAVE PERSONALLY EXAMINED AND
<br />ATION SUBMITTED HEREIN; AND BASED ON MY
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<br /> INQUIRY OF THOSE INDIVIDUAL S IMMEDIATELY RESPONSIBLE FOR OBTAINING ~ //
<br />..IC)ld TeCli ,' I'I~ THE INFORMATION, I BELIEV E THE SUBMITTED INFORMATION IS TRUE, / ~ ~
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<br />TIES FOR SUBMrI'TIN
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<br /> POSSIBILITY OF FINE AND IM SONMENT. SEE 16 U.S.C.
<br />1001 AND 33 U.S.C.
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference a((adecnmenrs Here)
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<br />EPA Form 332x7 (08-95) Previous editions mey not be used. (REPLACES EPA FORM T-40 WHICH MAY NO7 BE USED.) n ^ f n „ ~ ,t fl 1 r 7, T ~ , r, PAGE OF
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