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<br />PERMITTEE NAMEIADDRESSpMrb P«:bryNw/L«auar pD~.r.np
<br />NAME ...'Y J'~j"~ ".. r -.i '--i ~: ~~
<br />°'1"E~~ ~~ ~='' CO 4.7115
<br />FACILITY
<br />LOCATION
<br />5".'"f: ~M~J~ pT.° ;. ~ '. r, T,"', ;EN°R.4L 4'VY
<br />NATIONAL POLLUTMT DISLHMOE ELIMINATION SY9TEM lNPDES)
<br />DISCHARGE MONITORING REPORT /OMRI
<br />1-I5I l17-191
<br />:1^'l2 /li'i ^~F a
<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD ,
<br />YEAR MO DAY YEAR MO DAV
<br />FROM ~ ~ J TO ~IY q 7'I
<br />!16211 /11-131 11b151 !16(71 /18-191 !36311
<br />Form Approved.
<br />e• . y o T ', ~• .; :. T; IOMB,No~ 20~~00~0~4yF v
<br />~..I Approval e~Pl ;05=31-98
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<br />1 NOTE: Reed Inetructlom bsforl comp etinp thu form.
<br />PARAMETER !3 Grd On1Y1 QUANTITY OR LOADING /1 Grd Onlyl QUANTITY OR CONCENTRATION ` ND FREQUENCY SAMPLE
<br /> !46531 !546/1 138-I5I !4653 !54611 DF
<br />I3T-371 EX
<br />MµY9S TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !e1-e]I !5e-egl !53701
<br />.:vYilii C'C L'/IT4 SAMPLE .. YFkh h:•^-~#'c '.:G#'.<'X • ( ll)
<br /> MEASUREMENT
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<br />;7',3U 1 U S PERMIT ;cJt#rcC.:` ~.'y;F;cr,,#- ;s'.-~ .~-##. .. 35 'F !t t '.Nr;r/ •R1.?
<br />':'=L'J6NT Sr1J59 V4[.^' REQUIREMENT ~:kt`. ~Opn ,n,Y^ r;RT•It xx ~~:/i, q[)r;~r,l
<br />=':LL'J5, ScTTLF'a ?LF; SAMPLE +;c•.•er:;:: {e :t~,.ev;•: #Y,:#:7-: :` { )~~)
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<br />)0545 1 U (1 PERMIT 'e+x:~Fh;x ,t##9/5:# #{ct k#'!$#'Y RF D(1 A'r Ac P(1 {?"' ( ?~^^/ 'DA%
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED MD
<br />AM FAMILIM WITH THE INFORMATON SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE
<br />R(zfhard Mlll~ MY INQUIRY OF THOSE INDINDUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTNNING THE INF011MATON, I BELIEVE THE SUBMITTED INFORMATION IS
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<br />L- TRUE, ACCUMTE MD COMPLETE. I AAI AWME THAT THERE ME
<br />SIONIFILMT PENALTIES TOR BUBMITTINO FALSE INFORMATION
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<br />THE POSSIBILITY OF RNE MD IMPRISONMENT. SEE 18 U.S.C. ! 1001 MD ]3 SIGNATURE OF PRINdPAL EXECUTNE
<br /> U.B.C. ! 1310. lPrxeYA UMw dxr mem.,rx14rcA.dA rxxa y ro 110,000
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference sll ettechmenfs here!
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<br />EPA Form 3320-1 (08.951 Prevloue edrbone mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.1 PAGE OF
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