HYDRO23019

• Permit No: C1994082
• IBM Index Class Name: Hydrology
• Doc Date: 10/19/1999
• Doc Name: 2nd Qtr 1999 DMRs
• Permit Index Doc Type: DMR’s
• Media Type: D
• Archive: No

PERMITTE~NAME/ADDRE$$(Include factlrm Name/Location ifDiffcrenU NA'
NAME SENBCA CCAL CClPlNI
ADDRESSgR6YER D
NAYDEN CO 41639
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LOCATION A ~ U h S ~~ . CQ~;sdS E 30 FROM
di4'N: G. RUO B80MN, GE'~:.RAL FIEj
)NAL POLLIJTANY DISCHARGE ELIMINATION SYSTEM (NPDESJ Form Approved. -
DISCHARGE MONITORING REPORT (DMR) OMB No. 2040-00046'
(z,sJ nz-s) CLNCY
4.G.OO.L~27 0 1 A (SpBR NY) Approval expires 05-31-98
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NAMERITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSO
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ON SUBMITTED HER NALLY E%AMINED AND
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AND flASEO
N MV TELEPHONE ~ DATE
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INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING ~ '
THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE, ~
ACCURATE AND CQNPLETE. 1 AM AWARE THAT THERE ARE SIGNIFICANT
PENALTIES FOR SUBMITTING FALSE INFORMATION
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SONMENT. SEE 1a U.S.C. § 108t AND 33 U.S C. SIGNATURE OF PR r CIPAL EXECUTIVE

TYPED OR PRINTED § 1319. IPenalaes untler these stables may include Hnes up lo. Ete,ODO entl or
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NUMBER
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COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) -
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EPA Form 3320.1 (08-95) Previous editions may not be used. - (REPLACES EPA FORM T-40 WHICH MAY NOT BE U$ED.) A :~ PAGE OF
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