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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MPDES) Form AppfOVad.
<br />DISCRARGE MONITORING REPORT IDMR; OMB No. 2040-0004
<br />la'si I+~- 91 ' ' ~ "'" ~ Approval e>~ires OS-31-98
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<br />NAME/TITLE PRINCIPAL IXECUTNE OFFICER I CERnFY UNDER PENALTY OF
<br />M FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSO
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<br />, PENALTIES FOR SUBMITTIN
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<br />SIGNATURE OF PRINCIPAL E%ECUTIVE
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<br />TYPED OR PRINTED 4 1318. (PeneRles antler theca steMac may /nclutle Imes up b 510,000 erM or
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<br />NUMBER
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all ettachmerlL3 here)
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<br />(REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.)
<br />EPA Form 3320.7 (OB-95) Previous editions may not be used* ~ ,t ,~ T r /' i r ll 1 ?- ~ r, ~ I( PAGE ~ OF
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