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<br />AT'TN: K.AdLA RAEGCK, V? ~i:• PRESIDENT
<br />nwrloN wL FoLL~rw Nr D1scN ARCL LCYMINwraDN srsrLM (NPO£SI
<br />DISCHARGE MONITORING REPORTlDMRI
<br />116 I L/9
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<br />MONITORING PERIOD
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<br /> Afr REM[NaT , & ~
<br />NAME/TITLE PRII{CIPAL E%[C UTIVE OFPICER ' C[RTIFr UNDER YCI4LTr QF LAW THAT I NAVE PERFANAIIV ~E%AMw[D
<br />ANO AY FMIILIYI MTN TNE VIipIMATIDf1 SUBMITTED HEREIN
<br />AND MBED TELEPHONE D A T E
<br />:,
<br />' / '
<br />
<br />' -' ON MY 1NWIBT OF .TllOfi[ INDIVIplAlS IMM[dATLIr R[SFONSIBLC
<br />FOP
<br />• ~
<br />/
<br />`
<br />OBTAINING TN[: INFOIIWTIO:1. I -BEUEVC THE' SUBMITTED
<br />~+MFORMAT
<br />Karla' Rabuck IS TRUE. ACCUFATE .(.NO COMRETE I AM ARAR[, TN1T TNCRL ;ARC. 51~
<br />NIFICAMT PEMA
<br />TICS FW SUBMTING FILLSE INFORMATION INCLUpNG (A /J/
<br />_
<br />
<br />'
<br />`
<br />Vice PResident TNE YOrSI&LITr OF FIN[ ANO IMYRRONY[NT SE["IB uSC f 1001 AnD
<br />J] V SC 1 IJ19 ~ /PrrY llv. uMrr MrI .lalulr. mar wf/W)I
<br />lIYI
<br />)Intl u
<br />lu lI1I SIGNATURE OF PRI CIPAL E%ECUTIVE 50E1 754=2291 93 ~ 1
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<br />'~ TYPED OR:PRINTEO =•d.,. nu~e.mn iwYnx,n.nnr.d M...n EIILmIh.aM .i ...ul II
<br />OFFICER OR AUTHORIZED AGENT
<br />)` A
<br />NUMBER
<br />YEAR
<br />MO DAY
<br />COMMENT AND E%PLANATION OF ANY VIOLATIONS (Rejnrnrr ull uuuohmrnlt hrir)
<br />SETTLEAELE SOLICS LIRI'T F.YFLIES ONLY Ir <= lU-YR, 2c-dfs E'AZC1P cYe"HT iS CLAIMzL. Ir' CLAI": APPROVF:C BY
<br />Y;;CD, T55 G IRON LI15IT5 TILL NOT BE 6PPLIED TO AEPOftTl;C tik:ASUHEl1EhT~--SL'E I.fi.1H, PG ~ n1iC I•E.1L, F'G 6.
<br />r RSV. nl UB Id%BU09 maybB USe(1. (RVLAC[[ [IA PD RM TJe WNIOM MAY NOT BE O[[D.1 ~ T ~ I ~-i (~~ J -AC[ oP
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