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<br />NATIONAL POLLUTMT DISCHMOE EUMIMATON SYSTEM /NPOESI Form Approved. - .
<br />DISCHARGE MONITORING REPORT IDMRI , .. ,. ,I ~ . , r ; , Mp{~,,No 204(1-0004
<br />(?-161 l17-191 ! A 1 ~ " I ..9 :-1 -, '1
<br />CG 0 0 ~:/ 0 ~: I ('1 f A (_, I! F ,ri F ~ ~ Approval(sxpir~8~05-31-98
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<br />l74I1/ I22-731 121-? !26771 !7B-I91 /34311 NOTE: Raed Inetructlane Mfore eompletinp this form.
<br />PARAMETER !3 Gre ONYI QUANTITY OR LOADING 71 Grd Onhl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE
<br />l3I-371 /!6531 !545/1 /38-451 14653 I54-611 EX of
<br />TYPE
<br /> AVERAGE MAXIMUM UNI MINIMUM AVERAGE MAXIMUM UNITS 137.6JI 'wuYaB
<br />/64681 /5&701
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENILLTY OF lAW TNAT I HAVE PERSONALLY E%AMINED AND
<br />AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN
<br />MD BASED ON \ TELEPHONE DATE
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<br />MY INQUIRY OF TXOSE IMDIVIOUAlS IMMEDIATELY RESPONSIBLE FOR
<br /> OBTNNING THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION IS
<br /> TRUE, ACCURATE MD COMPLETE. I AM AWME THAT THERE ME
<br /> SIGNIFICMT PENN
<br />TIES FOP SUBMITTING FALSE INFORMATION
<br />INCLUDING
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<br />THE POSSIBILITY OF qNE MD IMPRISONMENT. SEE 18 U.S.C. ! 1001 MD J3 gIOMATURE OF PRIN AL EXECUTR/E
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