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<br />NAME PUli l)~F. iIUF. I. Cpl~L C')'FnhY
<br />ADDRESS iLUAU~;;!)t: ;,I I:; , p _ ; ~)gTALS
<br />P.U. E file 11: J'.1
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<br />' NA710NAG POLLUTMT OISCHMOE EIIMINAiION SrBTEM (NROFSI
<br />DISCHARGE MONITORING REPORT lOMRI
<br />T-ISl lI7-191
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<br />PERMIT NUMBER DISCHMGE MUMSER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM y? la ;;1 TO l~ Of: 3~
<br />!16711 !TT-731 ITL151 IT6T71 IT9-191 !30.311
<br /> Form Approved.±,~,;
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<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !sz-s31 l54fiBl 159-701
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMIMED AND j
<br />/ TELEPHONE DATE
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<br />THE PoSSIBIOTY OF RNE AND IMPWSONMFNT, SEE 1B U.S.C. E 1001 MD 37 BIONATURE OF PRINCIPAL EXECUTNE r~
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<br />TYPED OR PRINTED .ndnnr.YitN.nirp~ianwntWbnY.Nremmrhs rWByral OFFICER OR AUTHORIZED ADENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRe7erencs e// etteenmenn nerel ~
<br />-.:-T'fLEAdLd Si.`Liv> LIn1I APPLlr'.:i GhLY IF C=17YF'.,lvn)r faLC:}ITt~TIC!r FYIf~°. IS CLAIPEL. i°=:~MT?T t° :~1AS
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<br />EPA Form 3320-1 108.95) Previous editions mey be used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.) PAGE OF
<br />CU~`i7/9'IC~:3-1.25'
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