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PERMITTEE NAME/ADDRESS pweY4 FrelryNa.JEmYIm gD,d..w9 - , <br />NAME TRAPPER nIXL::II:, INC. <br />ADDRESSTP.APPHR !TEE <br />P. o. RnX t~- <br />CF.ATi; C'Ci d16tb <br />FACnm <br />LOCATION <br />ATTIIi a. GJ1i;1JH D""'YR ~ 4RF.5/GEN 1f;R <br />i. <br />!' <br />~i <br />IUTANT DISCHMOE ELMINATON SYSTEM /NPOESI Form Approved. <br />1ARGE MONITORING REPORT IOMRI ~ OMB No. 2040-0004 <br />/I-161 I7-/91 '1T ~1U, <br />(4 U R R W 1f~ APProvsl expires 05-31-98 <br />IT NUMBER D19CNARGE NUMBER P - F T p~ I. ~ 1 c A r <br />MONIT RHVGPERIOD P77D 'E'. :1FFR .ZILCH <br />MO DAY YEAR MO DAY <br />,TO ~ I kR4 N7 DT, SCHAR~F (~[ 4hR <br />!11-13/ 11I-151 !16271 118-19I /30.3!! 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NX" !1r/T, <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER 1 CEPTIFY UNDER PENALTY OF <br />AM FAMILIAA VATN THE INFO LAW THAT I HAVE PERSONALLY EXAlA1 <br />RMATION SUBMITTED NEREIN; AND B N AND <br />ASED ON - TELEPHONE DATE <br /> <br />MY INOUIM OF TNOSE INdNDUALS IMMEDIATELY PESPONSIBLE FOR ~~ <br /> <br />~ <br />N. GOrdOL POtare TDR{E,FIAC[URATEFANDACOMPLETE.I~ETAMSAWAREETHIAT THERE N1E <br />ITTING f <br />INCLUDING <br />F <br />N <br />f <br />ISE INFORMATION <br />T <br />B ~ <br />/'~'~ <br />~ 970-824-4401 99 04 30 <br />President /13antral Manager ICANT PE <br />, <br />SIGNI <br />AL <br />IES <br />OR SU <br />M <br />A <br />THE POBBIBIIITY OF qNE ANO IMPRISONMENT. SEE 19 U.S.C. i 1007 AND 33 BIONATURE OF PIIINCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED - U.S.C. f 1318. 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