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PERMITTEE NAME/ADORE88 (1.hL FsNryNwr'Laeauw gDlp...e0
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<br />ADDRESS ~~\ L. 1 F : ' J , .. r ; -. .C N p N D {
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<br />NATIONAL POILUTMT DISCHMOE ELIMINATION SYSTEM INPDESI
<br />DISCHARGE MONfTORING REPORT (OMRI
<br />!Z-1 el 17- I91
<br />PERMIT NUMBER DISCHMOE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 3 I):f J TO ~'1 " + ~'
<br />114211 122-231 124251 /16171 l18-191 !34311
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<br />Form Approved.
<br />,.-,OFdB,No~20A0-0004; a•
<br />Approve4 e><pires 05-31-98
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<br />NOTE: Raad IrutrucUone bolas oompletin8 this }orm.
<br />PARAMETER !3 Gtd On/yl QUANTITY OR LOADING l~ GN OntyI QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
<br /> !4653/ 151811 138-<51 !4653 /5451/
<br />EX DF
<br />TYPE
<br />l3Z-371 MALY515
<br /> AVERAGE MAXIMUM UNITS E MAXIM
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<br />MINIMUM AVERA
<br />G let-69I !54581 159-701
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENN.TY OF LAW THAT I HAVE PERSONALLY E%AMINED MD
<br />AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN; MO BASED ON TELEPHONE DATE
<br />
<br />Richard Mills MY INQUIRY OF THOSE INDIVIDUAI9 IMMEDIATELY RESPONSIBLE FOR
<br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION 19
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<br />~ TRUE. ACCURATE MD COM0.ETE. I AM AWME THAT THERE ME
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<br />SIGNIFICMT PENN
<br />TIES FOR SUBMITTING FN
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<br />THE PosSIBILITY OF RNE AND IMPRISONMExT. SEE 18 U.S.C. f 1001 MD 9] BIONATURE OF PRINCIPAL EXECUTIVE
<br /> U.9.C. f t 91 B. !/irWtl.. ~qr eM« mom. ~Y IxA,b taa « ro t 10,000 AREA
<br />TYPED OR PRINTED snd rrnui«.rl inpionlnfofMM«nemonNSWeyeva/ OFFICER OR AUTHORIZED AOENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION Or ANT vwLA I wns 1lrererence an erroenmenre nets)
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<br />EPA Form 3320.1 108.951 Previous editions mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.) PAGE OF
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