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<br />NAME/TI7LE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT 1 RAVE PERSONALLY E%AMINED AMD
<br />AM FAMIUM WITH THE INFORMATION SUBMITTED HEREIN: µ0 BASED ON i
<br />1 TELEPHONE DATE
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<br />MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY pESPONSIBLE FOq
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<br />I /(.j7Qj8]0-2712
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<br />THE POSSIBILITY OF FNF µD IMPRISONMENT. SEE 18 U.S.L. 1 1001 µD 73 N
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<br />PRINCIPA
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<br />TYPED OR PRINTED
<br />ArgrmulmAn Mrraelvr orawwnemmeL rM6yws.l
<br />OFFICER OR AUTHORIZED AGENT
<br />COlE NUMBER YEAR MO DAY
<br />NATIONAL POLLUTANT DISCHAgOE ELIMINATION SYSTEM INPOESI Form Approved.
<br />DISCHARGE MONITORING REPORT (OMRI . , , OMB~No: 2040-0004_
<br />17-161 17-I91 '
<br />C O 0 ~ . % . > 'I n (1 A - ~ t Approval ejLpiTPy OS-31-98
<br />PERMIT NUMBER DISCHARGE NUMBER ~~ _ .
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ,. TO ~ _ _. ~ I .
<br />176711 l77-231 I1F75/ 116-371 /7B-291 !3431/ NOTE: Reed imtrueUda before compbtlnq this form.
<br />COMMENTS AND E%PLANATION OF ANY VIOLATIONS lRaference a//etfsehments hare!
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