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PERMIITEE NAME/ADDRESS l1. .. FxeiryNww//a•rlon dDlD..ee)
<br />NAME nJwlc 3c:;~;~,;;;;9, LL".ITr_G
<br />ADDRESS F1 a ~ I :. ~~ • r + I •:..
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<br />FACILITY
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<br />NATIONAL POLLUTANT dSCNAROE ELIMINATION SYSTEM (NPOES/
<br />DISCHARGE MONITORING REPORT (OMRI
<br />l7-I61 117-191
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<br />PERMIT NUMBER DISCNMOE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ~ q f7 ~ TO ~.
<br />/96911 /99-J31 /11951 /?6-571 /?9-791 /3Q311
<br />Form Approved. ,
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<br />PARAMETER !3 fird Onlyl QUANTITY OR LOADING !I Cerd OnIYI QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
<br /> !16-53 l54-611 !38-45 !4653/ l5F6/1 EX µ TYPE
<br />131-371 µ
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<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS lsme7l 164-687 !63701
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDD1 PENN.TY OF
<br />AM FAMILIM WITH THE INFO LAW TNAT I HAVE PERSONALLY EXAMINED AND
<br />RMATION SUBMITTED HEREIN; AND BASED ON TELEPHONE DATE
<br /> MY INQUIRY OF THOSE INDINOUN.S IMM WIATELY RESPONSIBLE FOR
<br /> OBTNNING TIE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS
<br />RE TNAT TH
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<br /> TRUF, ACCURATE AND COM
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<br />NIRCANi PENALilES FOR SIIBMIITING fALSE INFORMATION
<br />WCLUDING , I
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<br />THE POSABIUTY OF RNE AND IMPRISONMENT. SEE 18 U.S.C. 1 1001 AND 77
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<br />SIGNATURE OF PIIINCMAL EXECUTIVE
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<br /> U.S.C. f 171 e. fFYMM• MrI•r N•w Nrrmr• rn•Y icA.d• r•w• Ip ro S IO,ODO
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<br />TYPED OR PRINTED
<br />rww,na.hwni:p/o++wN el Nn•wn smmN•rd 6Y•A'a/
<br />OFFICER OR AUTHORIZED AGENT
<br />CODE NUMBER YEAR MO DAV
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Referents en stteenmsnts here!
<br />+:!1T!.E'ASLE S7Lt"; LI".I7 ApPLIc:. ;9LY IF := 10-YET, 24-fiq ?ri~,:ic cYcGI 15 CLAT":L:. IF '~Lat•' IS \kTnR;YF~
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<br />EPA Form L3y20- t S- Pro ' e d InonB mey e• Bd. • - -1 EPlACES EPA FORM TAO WHICH MAY NOT BE USED.) PAGE OF
<br />t?571 /'i~~;7L'L-l5)r 1
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