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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMRI
<br />(2-I6) (I]- 9)
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<br />PERMIT NUMBER --' ISCHPAGE NUMBER
<br />MONITORING PERIOD
<br />YEA MO AY YEAR MO DAY.
<br />FROM ~ TO ~ S 1 i 1
<br />(2621) ; ~ 3), (Z4-25) (2G2]) (1829) (3(Y31)
<br />Form Approved. -
<br />OMB No. 2040-0004
<br />C I N C F Approval expires 05-37-~~
<br />(SUcA FC)
<br />F - FItAL EITAM
<br />CC: CCi CC"fJ!EC CiCEFC
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<br />NOTE: Read Instructions before completing this form.
<br /> (3 Cartl Ony) QUANTITY OR LOADING - (4 Caro Onry) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (46-53) (5461) (38-45) (46-53) (54-61) EX OF TYPE
<br />(32,37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM ,UNITS aNa-~)s
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO NALLY EXAMINED AND TELEPHONE DATE
<br /> AM FAMILIAR WITH THE INFORM ATION SUBMITTED HEREIN: AND BASED ON MY
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<br />S-IaVSE'- INQUIRY OF THOSE INDIVIDUAL
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<br />I BELIEV S IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />E THE SUBMITTED INFORMATION IS TRUE
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<br />ACCURATE AND COMPLETE. ,
<br />I AM AWARE THAT THERE ARE SIGNIFICANT
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<br />SIGNATURE OF PRINCIPAL E%ECUTIVE T/ 7' .
<br /> ud~siies up to E10,060 entl or
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
<br />iiD.'IITTEE f"U57 hCTIFY M(CL JC GAY` PAIOk TC CCKFIEI`iG f,I°C NAF6E5-FAFT I.A., PF IY. CChTELY SACF1IhG FCf
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<br />CCO50/95C71i-11C5 1
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