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PERMITTEE NAME/ADDRESS pndi6FrWryNa/Locsua pDlpr.nq
<br />NAME C O :.. -. ~ ~ ` l ~ . ~ L _ -' w ', (
<br />ADDRESS .9 I I _ • • _
<br />FACILITY
<br />LOCATION
<br />.. ri. ;~41, ~. _ ~ 'l..-. .i. / 711
<br />NATIONAL POLLUTANT DISCHMOE El1MINATION SYSTEM (NPDESI
<br />DISCHARGE MONITORING REPORT (OMR1
<br />11-I51 /I7-19I
<br />:77.950013
<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 9 d U4 J L TO J Q Ju J (:
<br />1161/1 l11-131 11I-151 116-17I 118-191 13x311
<br />Form Approved.
<br />~ r: I, I P :1>F D R U H~ F E' OMB No; 2040-00041 ;,
<br />Approval expiiee OS-31-98
<br />p _ rT •.IAL
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<br />NOTE: Reed instructioru before completing •this lorm.
<br />PARAMETER !3 Ord Onlyl QUANTITY OR LOADING !/ Ord Ontyl QUANTITY OR CONCENTRATION NG RIEQVENCY SAMPLE
<br /> !46531 154-5/1 138-451 !46531 154511
<br />EX of
<br />TYPE
<br />I31-371 ANUVSIS
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS let-sal 1y1-5B1 !5&701
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<br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW TNAT I HAVE PERSONALLY E%AMINED AND
<br />AM fAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON TELEPHONE DATE
<br />
<br />Ichard 1 tIIIs
<br />F MY INQUIRY OF THOSE IMDINDUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION 15 •'",
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<br />I AM AWARE TNAT THERE ARE
<br />ACCUMTE AND COMPLETE
<br />TRUE ~ % ^
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<br />NT PENALTIES FOR SUBMITTING FALSE INFORMATION
<br />INCLUDING
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<br />~(~~ 117D-2711
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<br />- THE POSSIBILITY OF flNE AND IMFTaSONMENT. SEE 18 U.S.C. 1 1001 AND as SIGNATURE OF PRINCIPAL EXECUTNE
<br /> U.S.C. 1 t 31 a. /PxW+w. Imes awr mum. mrr NcA.h llrw. w ro t )0,000 AREA
<br />TYPED OR PRINTED rlewmrinurn inp/rrune+=o/brw«n emmm.WSyrr.! OFFICER OR AIffNORIZED AGENT CODE NUMBER YEAR MO DAV
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rslsrence ell sttechmsnts hers!
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<br />?An: I.'1.1.:/, F.:. '~. .,:.11!'"eAT'rt !:ln;':`.:Sf PLA~J DUF I-L-:.S.
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<br />EPA Form 3320.1 108-951 Previous editions may ba used. /REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) U .I ,I `/ q T ,,, A 1 q _ T ~ ~ L PAGE OF
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