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<br />ADDRESS TRAPPER RIME'
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<br />FACILITY
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<br />NATIONAL POLLUTANT gSCHAROE ELIMINATION lYSTEM (NPOESI
<br />DISCH1 R61E MONITORING REPORT (OM91
<br />PERMIT NUMBER ascHARGE NUMBER
<br />MONITOR G PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM TO
<br />1IP111 172-131 III.151 !76271 116-191 l3aJJ1
<br />Form Approved.
<br />!1 L Y 0 A OMB No. 2040-0004
<br />(SORB MY) Approval expires OS-31-98
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<br />NAME(TITLE PRINCIPAL EXECUTIVE OFFICER ('CERTI
<br />AM FA FY UNDER PENALTY OF LAW THAT 1 NAVE PERSONALLY EXAMINED AND
<br />MILIAR WIT/1 THE INFORMATION SUBMITTED HEREIN
<br />AND BASED O TELEPHONE DATE
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<br /> MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPON4BLE FOR
<br />OBTAINING THE INFORMATON, I BELIEVE THE SUBMITTED INFORMATION IS .
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<br />W. Gordon Pet~re TRUE, ACCURATE AHD COM0.ETE. I AM AWARE THAT THERE ME
<br />SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING ~
<br />970-824-4401
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