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pERMITTEE NAME/ADDRESS prlr4Fr14ryNaWlaanon OD.p,.m0
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<br />NATIONAL POLLUTMT DISCHMOE EUMINATON SYSTEM INPDESI FOfm Approved.
<br />DISCHARGE MONITORING REPORT /DMR1 . , _ ~ ~• -OMB•No.,2040-0004
<br />!1•I6l I7-191 I
<br />- • ~ ~•. ~- , i ~, , - - ~ ~ Approve! expires 05-31-98
<br />PERMIT NUMBER DISCHMGE NUMBER _ - ,
<br />' MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV _
<br />FROM TO . .... T -, I 1
<br />!14111 111-131 114151 116-171 l18-191 130-3/1 NOTE: Read Inetructlom bslwe completlnp thu form.
<br />PARAMETER 13 Grd On/Tl QUANTITY OR LOADING !4 GId OnNI QUANTITY OR CONCENTRATION NO. FREQUENCY SAMPLE
<br /> 106-531 151-6/1 138-~51 146-53 I5L6/1 OF
<br />l31-371 EX MALrss TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !sa-ss~ 164681 !69701
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<br />NAME/TRLE PRINCIPAL EXECUTNE OFFICER I cERn
<br />AM FA Fy UNDER PENUTr of uw THAT I HAVE PERSONALLr EzAMweo MD
<br />MILIM WITH THE INFORMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE
<br /> MY INQUIRY OF THOSE INDIVIDUALS IMM WIATELy RESPONSIBLE FOR
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<br />~1~1~ OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS '
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<br />• TRUE. ACCUMTE MD COM0.ETE. I AM AWME THAT THERF ME .
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<br />OFFICER OR AUTHORIZED AGENT AREA
<br />CODE
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<br />COMMENTS AND EXPLANATION OF Any v1ULA I IUNa Insrerence en etrscnmenrs nerel
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<br />EPA Form 3320.1 108.95) Previous editions may be used. IREPLACE6 EPA FORM T-00 WHICH MAY NOT BE USED.) ~ ~ - - • ~ _ ~ , ~ r ~ _ f f , PAGE - OF
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