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<br />NATIONAL POLLUTANT DISLHMOE ELIMINATION SYSTEM INPOESI FOrrD Approved.
<br />DISCHARGE MONITORING REPORT IDMRI .. I - - OMBt No/ 204p-0004,
<br />2-161 117-191 .". i
<br />_~ ~ ? ti G r~ i ~ ~ (", +'' APProvd e~pi4 a OS-311158
<br />PERMIT NUMBER DISCHARGE NUMBER ~ _ ~ .
<br />MONITORING PERIOD T ~' ~ '
<br />YEAR MO DAY YEAR MO DAV -
<br />126711 l11-231 114151 11617/ l2B-29/ 1363/1 NOTE: Raad InatTUCtlaru baloFa complatlnll lhia lorm.
<br />PARAMETER l3 Grd Onlyl QUANTITY OR LOADING (I Grd OnIYI QUANTITY OR CONCENTRATION NO FREDUEHCr SAMPLE
<br /> 106-531 15d-611 I3Bd5/ /0653 r5b61 OF
<br />132-371 EX
<br />ANALrsls TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 161-a~1 /5F5B7 169-701
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI FY UNDFR PENKTY OF UW THAT I NAVE PERSONALLY E%AMINED AND TELEPHONE DATE
<br /> AM FA MILIM WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON
<br /> MY INQUIRY OF THOSE INDINDUALS IMMEDIATELY RESPON518LE FOR
<br /> OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS -
<br /> TRUE, ALCUMTE ANO COM0.ETE. I ANI AWARE THAT THERE ME
<br /> SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION
<br />INCLUDING
<br /> ,
<br />THE POSSIBILITY OF RNE AHD IMPRISONMENT. SEE tB U.B.C. ! 1001 AND 37
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