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<br />INATION SYSTEM (NPDESJ Fofm Approved.
<br />IEPORT (OMR; OMB No. 20400004
<br />lta 91 ~-.~-)1.
<br />Approval expires 05-31-98
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<br /> (3 Cerd Ony) O~IANTITY OR LOADING
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<br />NAME)TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED AND
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<br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING
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<br />PENALTIES FOR SUBMITTING FALSE INFORMATION
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<br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE to U.S.C. § 1001 AND 33 U.S.C
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<br />NUMBER
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<br />COMMENTS AND EXHLP.rvn I lurv ~r Arvr wuLA I lane (nererence an attecnments nere)
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<br />EPA Form 3320-1 (OSA5) Previous editions may not be used. (REPLACES EPA FORM T-00 WHICH MAY NOT BE USED.) PAGE OF
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