PERMITfEE NAME/ADDRESS p YJ. F.etlrryNaWVrmen UDIp...eq
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<br />FACILITY
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<br />NATIONAL POLLUTANT DISCNMOE EUMINATON SYSTEM /NPDESI
<br />DISCNARGE MONITORING REPORT (OMRI
<br />l1-15I 117-I91
<br />PERMIT NUMBER DISCNAAGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM 'J i ,` TO `1 r' 'I 1•I
<br />!7411/ l7I-731 !1415) l?6171 118-191 !3431/
<br />Form Approved.
<br />r . •~ n.... - ~. .. .. ..LOMB No. 2040-0004
<br />^„ _ ~ Approve! exp~ree.05-31-98
<br />(. f"1 Lt1-11
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<br /> !46531 /5461/ 138-451 !46531 154511 EX QF
<br />137-371
<br />ANAyY515 TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS /63~a]! !54581 189-701
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTI FY UNDER PENALTY OF L AW THAT I NAVE PERSONALLY EXAMINED AND ~ TELEPHONE DATE
<br /> AM FA MILIM NATN 1NE INFO RMATON SUBMITTED NEREIN; ANO BASED ON
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<br />.~~ THE POBSIBILITY OF FIME AND IMPNSONMENT. SEE to U.S.C. 1 1001 AND 33 gIONATURE OF PRINCIPAL E%ECUTNE
<br /> U.B.C. 1 1310. IMWW. uMr Mr corona m.r A1cA.d. lnr. ye ro f 10,000 AREA
<br />TYPED OR PRINTED ~/>nr+NIIL+11*A+IOTIIIenrWblwrn emmU. rM6 yria/ OFFICER OR AUiNORIZED AOEHi CODE NUMBER YEAR MO DAV
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