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PERMITTEE NAME/ADDRESS pwer4 F.eWry Nsr/Lacenm dDyFwO
<br />NAME ;:YP:3U i '~q> - t. -' _ _' „-
<br />ADDRESS ~ I if E$ I F Z E j ~ Il r' _ ~ , ." ~ ` 1 j .
<br />E'" :LFA'~l~ 'U ^'U1~';
<br />FACILITY •
<br />LOCATION
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<br />NATIONDISCLFIARGEDMON TORING REPORT IDMINPOES)
<br />2-161 17-191
<br />PERMIT NUMBER D13CHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM "' ~" :4 ) TO "~. 7 ~1'
<br />170-21/ !?2-231 114151 126171 118-191 130.3/1
<br />Form Approved.
<br />.-T.~^ ~ - -. r '~-,OtdB~No~2040-0004-""
<br />~ Approve e i s05-31-98
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENN.TY OF lAW THAT I HAVE PERSONALLY E%AMINED AND
<br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED OX TELEPHONE DATE
<br />t
<br />Richard
<br />Ii IC} OBTNNIONG THE MFORAIATIONDII^eE EVE NE SUBMITTED EI~ORMATION~S
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<br />Envlronment~( :Mana TRUE, ACCUMTE AND COMPLETE. I AM AWARE THAT THERE ARE
<br />SIGNIFICANT PENALTES FOfl SUBMITTING FALSE INFORMATON
<br />INCLUDING
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<br />X70-370-~71Z
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<br />77
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<br />THE POSSIBILITY OF RNE AND IMPNSONMENT. SEE to U.S.C. E 1001 AND 73 SIGNATURE OF PIIINCIPAL EXECUTNE
<br /> U.S.C. E 1310. +PwWS/ YWI dMM mwna mry M,[AIdI JYMS ~ ro S 10,000 AREA
<br />TYPED OR PRINTED .ed>mubwnirwls,++r~+r elbwwn emmNaW bY.ral OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLA I IVN~ IlTSrersnce en errscnmsnrs oars/
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<br />EPA Form 3320.7 (08.951 Previous editions mey be used. IREPLACEB EPA FORM T40 WNICN MAY NOT BE U8ED.1 PAGE OF
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