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<br />NATIONK POLLUTANT DIBCHARGE ELIMINATION SYSTEM lNPDESI Form Approved.
<br />DISCHARGE MON170RIN0 REPORT /DMR7 ~ p. r r [. v r ~ • r BrMp. 2040-0004
<br />17-761 If7-/91 ( ~ -. L T'?M .
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<br />PARAMETER !3 6rd Onryl QUANTITY OR LOADING !4 Ord OnIYI QUANTITY OR CONCENTRATION N0. FREQUENCY SAMPLE
<br /> H6531 I54-611 /3BJ51 I<6531 154-6E1
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<br />137-371 ANKY515
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS /sz-s.T/ I5a5Bl 15&701
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<br />NAMERI7LE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENKTY OF lAW THAT I HAVE PERSONKLY EXAMINED AND
<br />AM FAMILIAR WITH THE M/FORMA710N SUBMITTED HEREAY: AND BASED ON ~ TELEPHONE DATE
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<br />MY INQUIRY OF THOSE INDINDUKS IMMEDIATELY RESPONSIBLE FOR _ /
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<br />i Cr12T!~ ~/r. i' l2Tc'B)rl OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INfORMATION 16 r / ~ /I 'I ,
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<br />' TRUE. ACCURATE ANp COMPLETE. I AM AWARE THAT THERE FJ1E--
<br />SIGNIFICANT PENKTIES FOR SUBMITTING FKSE INFORMATION
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<br /> THE POSSIBILITY OF qNE AND IMPRISONMENT. SEE 18 U.S.C. 1 1001 ANp ]] g10NATURE OF INCIPAL EXECUTNE
<br /> U.S.C. f 1010. lP.rIFIeFIr uner N.~ mnm. nYY Arr.'Ard. Fin.. w ro f IO,ODD AREA
<br />TYPED OR PRINTED rw ar mluvnun MfviA.wwN Of MrwwnemalN..nd BYwa/ OFfICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAy
<br />`OMMENTS AND EXPLANATION OF ANY VIULAI IVNS !Reference s0 ettacbmsnfs bale/
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<br />Form 3J20-1 108.951 Previous editions may be used. (REPLACES EPA FORM T-40 WHICY MAY NOT BE USED.( PAGE OF
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