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PEgMITTEE NAME/AODRE55 (I~MF.eWryNsr/LxuIaI l/DJp+,.nq
<br />NAME TP.APPPR I'ils.IYG, INC.
<br />ADpgESS TRAPPER IlibE
<br />P. O. R:II 147
<br />cRArc co Rt~z6
<br />fACILITY
<br />EOCATION
<br />A??MS V. GORDDL PETEFS, PflES/CER }i5R
<br />NATIONAL POLLUTANT DISLHMOE EIJMIHATON SYSTEM (NPDESI Fortn Approved.
<br />DISCHARGE MONITORING REPORT lOMR/ OMB No. 2040-0004
<br />7-rsr n-13I !livElp
<br />Approvd expires OS-31-98
<br />(SUER Nu)
<br />PERMIT NUMBER ~ gSCHAgGE NUH1eefl P - * i N >t !. h 1 r A ~"
<br />ONI ORRJGPERIOD DiSC'NARn° 'G ~,0%1SF. f,JL[H
<br />YEAR M'~O'7 ~DAY YEAR MO DAY _
<br />FROMr"'~ ~ TO ~' Q5 3n aa# N1 nI SC11ARr, P. }.~~ ~aa•
<br />114711 l17-231 /71151 . /1617/ I7B-?81 130.311 NOTE: Reed Mlewedorr 6efor~ PNflnq dw form.
<br />PARAMETER r3 GrO OnYy QUANTITY OR LOADING ". ~
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<br />~ !I Grd OnNI QUANTITY OR CONCENTRATION
<br />~ N0. iREDDENCV S MPLE
<br /> 16531 15a-6r1 38-x5 X653 51-511 - DF
<br />l31-371 EX AH
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<br /> AVERAGE - "~ MAXIMUM UNITS ~ MINIMUM AVERAGE .MAXIMUM UNITS rs7•e]1 K
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<br /> MEASUREMENT
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<br />FFPLUENT GR'J55 Y11LU . REQUIREMENT trtrat TRSR l11'u D EL Rx MIC/L
<br />NAME(FITLE PRINCIPAL EXECUTIVE OFFICER I CEflTIFV UNDER PENKTY OF LAW THAT I NAVE PERSONALLY ExAMIN
<br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BA FD N+D
<br />SED ON ~ TELEPHONE DATE
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<br />GOLdan PetAra MY INQUIRY OF THOSE IHOIVIDUALS IMMEDIATELY gE5PON5lBLE FOR
<br />OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS
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<br />SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION
<br />iNCLUDIHG ' 970-824-b401 9 7 4
<br />President/General HadagAr ,
<br />THE POSSIBILITY OF FINE ANO IMPgI]OHMENT
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