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PERMITTEE NAME/ADDRESS N.d.d. FsWry Ns.arLxaua dD,Bin,rQ
<br />NAME C;Y:-J."~ - ~! - ;. ~~-•-,.
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<br />FacluTv
<br />LOCATION
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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION BYSTEM (NPDE$1
<br />DISCHARGE MONITORING REPORT (OMRI
<br />1-161 177-191
<br />i ;r 0'7715 '~ l'1C q
<br />PERMIT NUMBER DISCHAAGE NuNteER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM y ' J I TO "1 9 11 N ' '
<br />116711 111-131 174151 176771 !IB-79) !363/1
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<br />Form Approved.
<br />T.~OMBdVor~2040-0004 - r
<br />Approve! expires OS-31-98
<br />x NOTE: Reed inetrudlone belors eomplatlnp this form.
<br />PARAMETER l3 Grd Onlyl QUANTITY OR LOADING !I Grd On/yl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
<br /> !16531 I5b511 !38-65 /4653 /54-57/ EX
<br />l37-371 µuYyS TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS !s7-ssl /5<-581 !53701
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFOE LAW THAT I HAVE PERSONALLY EXAMINED AND
<br />IMA7rON SUBMITTED HERDN; AND BASED ON TELEPHONE DATE
<br /> MY INQUIRY OF THOSE INDIVIDUµS IMMEDIATELY RESPONSIBLE FOR
<br />kicizard h.9ills OBTNNING THE INFORMADON, I BELIEVE THE SUBMITTED INFORMATON IS
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<br />E TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE
<br />INCLUDING
<br />SUBMITTING FILLSE INFORMATION
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<br />SIGNIFICAlI
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<br />FOR
<br />THE POSSIBILITY Of FlNE AND IMPRISONMENT. SEE IB U.S.C. ! 1001 AND 3S _
<br />610NATURE OF PRINCIPAL EXECUTIVE
<br /> u.s.c.l tale. rArl.re'.A Mldv dur .error. mry L"tArd. rvrAwrorrG,osD AREA
<br />TYPED OR PRINTED .nsarnrAmen lnAVr'swrA,r O/NnrAw',enANd,AA•MerA.'A/ OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS Nrererence sn srrecnmenrs nerel
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<br />EPA Form 3320-t 108.951 Previous editions may be used. (REPLACES EPA FORM T~0 WHICH MAV NOT BE USED.1 n ~ ^ ,. ~ / ~ _ r r ,, ~ _ i ~ ~ PAGE OF
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