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PERMITTEE NAME/ADDRESS pMrb F.eWry Nsw/Loe+rrm dD~irarl
<br />NAME ~ Y :• ~ -. - .. -.
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<br />ADDRESS ' ; . .. . , ' .. . ' F .' ...
<br />FACILITY
<br />LOCATION
<br />NATIONAL POLLUTMT OISCHMDE ELIMINATION SYSTEM (NPOESI
<br />D18CHARGE MONITORING REPORT (OMRI
<br />12-161 117-191
<br />0107 71iU ^17 e
<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 5 1:. TO '! `/ ~ I1
<br />!2421/ 122-231 124151 126-271 128-291 !343/1
<br />Form Approved.
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<br />r ~ Approve, e%pi ~ee OS-31-98
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<br />PARAMETER !3 Qrd OnlYl QUANTfTY OR LOADING !~ Grd Onlyl QUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE
<br /> 146-531 !546/1 135-151 !46-53 !54511 E OF
<br />131-371 X
<br />µALY51S TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 162-eJl !54681 169-701
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<br /> MEASUREMENT
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<br />~O:1S0 1 0 7 PERMIT d-PJRY )PTFONAL x#~s'krxa r,.-',:tr~~':r; ,t;:~;:;.k ~:t,:~= c~r.>vY "q;mAy
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW TRAT I NAVE PERSONALLY EXAMINED µ0 TELEPHONE DATE
<br /> AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN; µD BASED ON
<br /> MV INOUIIIV OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
<br />Richard (.'Ills OBTNNING THE INFORMATION, I BELIEVE THE SVBMITTED INFORMATION IS
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<br />- TRUE. ACCURATE µD COMPLETE. 1 AM AWME THAT THERE ME
<br />SIONIFILMT PENALTIES FOR SUBMITTING FALSE INfORMATION
<br />INCLUDING / 970 ~70-Z71 ~ ~ ZO 9
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<br />anager
<br />Environmental
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<br /> THE POSSIBILITY OF RNE MDIMPw50NMENT. SEE IB U.S.C.I 1001 MD3S BIONANRE OF P111NCIPAL EXECUTIVE
<br /> U.S.C. f 13te. IPrWei+r+Wr 0w~ mew+ wl+v NepM l+r+ w ro J 10,000 AREA
<br />TYPED OR PRINTED +rVrr muimn. irrpiewwlr Pl hr..+.n 6mmev rW 6Trra1 OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
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<br />EPA Form 3320-T 108-95) Prevloue ednwnB may be used. IREPLACEB EPA FORM T-00 WHICH MAY NOT BE USED.1 ~ r ~ I, ~ ~ ~ ~ ., „., - T ~ .~ ~ PAGE i OF
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