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<br />NAME 1' DISCHARGE MONFTORING REPORT (OMRI
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<br />n e n ;~ ~r -- N u ^ Y fry '1 y ~ [ 2 ~` PERMIT NUMBER DISCHMGE NUMBER
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<br />FACILITY ~~ e r r U 1;~11 ~ r71 i t MONITOR G P D
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<br />LOCATION a.c. •i 7'.IR a^S~ ~ r ,^.0 411191 FROM 99 07 O1 1'O 9R 79 7
<br />A T T Y: ~ R 1 i !16111 l11-131 11415/ !16171 118-19) !3431/
<br />Form Approved.
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<br />pprbvel ex Irea 06- ~-98
<br />(SIJ9R Sr^.) 1234':
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<br /> (46-53/ 150-61 (38-15 /0653 I5L61/ OF
<br />131-37/ EX ANUrss TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 163.631 !641581 l5&70/
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<br />NAME(TITLE PRINCIPAL EXECUTNE OFFICER I CERTI
<br />AM FA FY UNDER Pf11ALTY OF
<br />MILIAR WITH THE INFO LAW TNAT I HAVE PERSONALLY E%AMINED AND
<br />RMATION SUBMITTED HEREIN
<br />AND BASFD ON TELEPHONE DATE
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<br />MY INQUIRY OF THOSE INDINDUALS IMMEDIATELY gESPONSIBEE FOfl
<br />OBTNNING THE INFORMATON, I BELIEVE THE SUBMITTED INFORMATON 19
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<br />1 TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT TNERE ME f
<br /> SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION
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