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PERMITTEE NAME/ADDRESS pneb6 FrWryNw/(,rrlon rJDtSiniv/ NATIONAL POLLUTMT DISOHMOE EUMINAgON 9VSTEM (NPDESI
<br />NAME z _ ., , _ DISCHARGE MONRORING REPORT (DMR!
<br />'-n,-~. '• 11-16'1 17-191
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<br />LOCATION t r + YEAR MO DAV YEAR MO DAY
<br />.;I L. :.7 F1 I]'. FROM 9 ~ (;!, ~7, TO ~ , I~~ ,fl
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<br />Fonn Approved.
<br />_ OMB No. 2040-0004 ,
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<br />NAMEli1TLE PRINCIPAL EXECUTNE OFFICER I OERTIFY LINDEN PENMTY OF LAW THAT I HAVE PERSONN.LY E%AMINED MID
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<br />MV INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOfl
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<br />EPA Form 3020-T 108-95) Previous editions mey be used. IREPlACE6 EPA FORM T~30 WHICH MAY NOT BE USED.1 PAGE OF
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