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PERMITCEE NAME/ADDRESS R.,~.b frYtryNar/laanan UDlair.nq
<br />NAME .iL+'...r. „;dL L;iJ"!FFi.Y
<br />ADDRESS L ~ „ ^ ~ tt
<br />FACILITY
<br />LOCATION ;: n l J :. !: , +
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<br />NATIONAL POLLUTMT DISCHMOE ftIMiNAT10N SYSTEM lNPDES!
<br />DISCHARGE MONITORING REPORT lOMRI
<br />1-16 I17-191
<br />PERMIT NUMBER DISCNMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 'f q L 'J TO Y O
<br />U2nf+ nPJ 71 nLfw+ /JAO)I /J^J 91 /.M.TII
<br />Form Approved. ,.
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<br />t. , Approval•ezpiree OS-31-,98
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<br />NOTE: Raad Iratructlerla bafora completing this form.
<br />PARAMETER l3 Ard Onlyl QUANTITY OR L DING 11 Grd Onryl QUANTITY OR CONCENTRATION NQ. FREQUENCY SAMPLE
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<br />l32-371 /46-53) 15461) ~ 138-15 146-531 I5beI1
<br />EX OF
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<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS IBl-say ANUysls
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<br />70
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTI
<br />AM FA FY UNDER PENUTY OF LAW THAT I HAVE PERSONN.LY EXAMINED MD
<br />MILIM WITH THE INFOAMATION SUBMITTED HEREIN
<br />MD BASED ON ~ ~ TELEPHONE DATE
<br />
<br />I1 is (] N Q S ;
<br />MY INQUIRY OF THOSE INDIVIDUKS IMMEDIATELY RESPONSIBLE FOR
<br />DBTNNING THE INFORMATION
<br />I BELIEVE THE SUBMITTED INFORMATION IS 1
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<br />TRUE, ACCUMTE MD COM0.ETE. I AM AWME THAT THERE ME
<br />SIONIFIGMT PENALTIES FOR 9UBMITTINO FKSE INF011MATION
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<br />THE POBSIBILITY OF RNE AND IMRIISONMENT. SEE +8 U.S.C. 1 +00+ MD 75 ION
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<br />COMMEN IS AND EXPLANA710N VF ANY VIULA INNS IflllafaDCa a//e(feCOmsn f9 bare/
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<br />EPA Form 3320-T 106-56) Previous editions mey be used. (REPLACES EPA FORM Td0 WHICH MAY NOT BE UBED.1 C c C ? 1 / q 7 7 G 31-15 t 3 PAGE 10F
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