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PERMITTEE NAMEIADDRESS BAdrL irWry Ns.Wlaeum rfDllfirm(p~ NATIONAL POLLUTAN
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<br />ADDRESS K ~' y is L .r 1' i y '~ ' ^ 1'1 rl U ) "
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<br />VPDfSI Forrn Approved. 1
<br />Pl r~ r ^. l u B No.~,2 04
<br />(~ 1, c 7 ,_ „) Approvel~xpi(~sr05-31.96
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<br />PARAMETER l3 Grd onlyl QUANTITY OR LOADING !d Onhl QUANTITY OR CONCENTRATION N0. FflEQUENCY SAMPLE
<br />13I-371 146531 15681 /3B-051 /4653 /51-811 EX DF TYPE
<br /> AVERAGE MAXIMUM U.
<br />NI MINIMUM AVERAGE MAXIMUM UNITS
<br />163-6]1 ANAirsls
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<br />15s7o~
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<br /> MEASUREMENT
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<br />A :;-~kCOli~4 ( 19~
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<br /> MEASUREMENT
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<br />NAME/i1TLE PRINCIPAL EXECUTNE
<br />FICER 1 CERTIFY UNDER PENALTY OF LAW TNAi I HAVE PER$ONµLr EAAMIN
<br />AM FAMILIAR MATH THE NFOflMAT10N SUBMITTED HEREIN; ANp BA W AMD
<br />SED ON TELEPHONE DATE
<br />I MY INQUIRY OF THOS INDINDUAl9 ILIMEDIATELr REBPDNSIB LE 'FOR ~+
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<br />OSSIeIUTY OF RNE AND IMP
<br />1150NME)IT. SEE 18 U.S.C. f 100 I
<br />] 610NAilR1E OF P111NCIPAL EXE
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<br />TYPED OR PRRiTED U.S.C. 1 1 ]1 B. lAxuler. ~Wr Nr~ m11mA 11•.Y {`•rA/I A'nrA lq N
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<br />OFFlCER OR AUTHORQ!ED AOENT
<br />COB' NUMBER
<br />YEAR
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS 1R67arinee N/ sttechmsnfs herel
<br />S'I `AY SV 4:r I, YI. .,. ~""11. LY {V :. r.U TK; ,tI JI1. FA~ SEF I.R. .
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<br />EPA Form 3320.1 108-BSI Previous editions may be used. (REPLACES EPA FORM T10 WHICH MAY NOT BE USED.1 p 0 D 7 6 / v 6 t$13 - i 2 2 i PAGE )OF
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