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PERMITTEE NAME/ADDRESSp~bfrreryNw/Txmws //DIp..,p
<br />NAME ;;gAti7 Y-.LL' • C~>: (. ::;11pAVY
<br />ADDRESS [911 tiG1.Y CAl;Y^h MI `.. ;~
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<br />LOCATION FRI
<br />ATTK: JDHrI !!. ~+.I?r;FS- Y.S 'IAGFIi
<br />Form Approved.
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<br />'( =~ II ': ` H J (;~ ApprovelLe~p~ras405-31-98
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<br />`NOTE: Rud NN1IDIICtlo1Ml M/O~ a °ol'~,SSRR^M"_•_dnp this form.
<br />PARAMETER !3 Grd On/y/ QUANTITY OR lOA (4 drd Onty) nuANnTY OR coNCENTRATION NO. FREQUENCY SAMPLE
<br />l32-371 !1653 /51-61 l38-I5/ !!653 /5461/ EX ANALYSIS TYPE
<br /> AVERAGE MAXIMUM S MINIMUM AVERAGE MAXIMUM UNITS ru-ra (6.r-68/ 16670)
<br />lY - SAMPLE .. , . . .. ~ ~ ~30G ( 12)
<br /> MEASUREMENT O f~ ;~7/~ r
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<br />J11. ;,r.D '.;dF,BSE SAMPLE .. : .. ...... . ,.. .. ( Iq)
<br /> MEASUREMENT
<br />) S1" L 1 O U ~~.~~. PERMIT `: ,T ^.; Y};: ,c :: K:'."•° rC: =..::: -: ,. •,. •.~~;
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<br />NAMERITIE PRW AL EXECUTNE OFFICER I CERTIFY UNDER PENfLTY OF UW TNAT I HAVE PERSONN,.LT EItAMI
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<br />AM FAMIUM WITH THE IN
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<br />MY INQUIRY OF THOSE IMDIVIDUAL9 IMMEDIATELY RESPONSIB
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<br />JOHN M wAL~reas OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMA TOR IS
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<br /> THE POSSINUTY OF RNE MD IMPWSONMENT. 9EE f B U.S.C. 1 1001 AND 31 T
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<br />d1pNATURE Of rRINCNAI EXECU
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<br />OFFICER OR AUENORIZED AGENT
<br />CODE NUMBER YEAR MO DAV
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRAarence e// rttecnmsnrs oars/
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<br />EPA Form 3320-1 (08.951 Previous editions may be used. (REPLACES EPA FORM T40 WNICN MAY NOT BE USE0.1 U U 14 `T /'~E 121 Y-120 6 PACE ~IOF
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