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PERMITTEE NAME/ADDRESS (Include Facilirv Name/Location i~Digrrem)
<br />NAME PICKETYSBE FNCCEESINU, LLC
<br />ADDRESS(; g ye L i( t I H E
<br />1311 BNENILCCL IFIYE
<br />FACILITY EYANSYIiLE IN 47711
<br />LOCATION F; g C N C 0 E 1 C 91
<br />AI'IN: AL kE.RHY, !"AF4CEk
<br />NATIONAL POLLl1TANT DISCHARGE ELIMINATION SYSTEM (NPOES) Form ApprOVed. -
<br />DISCNARGEMONITORING REPORT (DMR; OMB No. 2040-0004 ,
<br /> Approval expires 05-31-98 T
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<br /> PERMIT NUMBER DISCHARGE NUMBER , - F I b A l I A" N L
<br /> MONITOEIING PE610D rhACEF ACiL 7/FLi6 J4Cl Ft FIY:F
<br /> YE:A MO DAY YEAR MO DAY
<br />FROM .,fib. ~, r,1r NG ilEC'M~~ 162 )~ ;~~
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<br /> (3 Cerd On/yJ QUANTITY OR LOADING (4 Cerd Onty) QUANTITY OR CONCENTRATIQ NQ. FREOUENC SAMPLE
<br />PARAMETER (46-53) /54-61) (3$-45) (46-53) (54-6 EX OF TYPE
<br />f32-3]) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />(02 ) ANaLYSIs
<br />(64-6$)
<br />69-70
<br />P1' SAMPLE R91P94 #Sfi40~ 4id9C~ ( ~
<br /> MEASUREMENT
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM UW THAT I HAVE PERSO
<br />ATION SUBMITTED HERE NALLY EXAMINED AND
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<br /> INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />~ ~ P~ r r THE INFORMATION. 1 BELIEVE THE SUBMITTED INFORMATION IS TRUE, ,
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<br />7 ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/erence a/I attachments here)
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<br />EPA Form 3320-1 (08-95) Previous editions may not be used. (REPLACES EPA FORM T~(1 WHICH MAY NOT BEMUSED.) ] C (G 19 / C G G 1 1 J -1 E ~ Q C C PAGE 1 OF
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