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PERMITTEE NAME/ADDRESS lIrYJ. F,eWyNr/focmr dDta.~a - - - -
<br />ADDRESS TERROR CBte:I LOAOJUT III IIIIIIIIIIIIIIII
<br />EB40 NIGRNd[ 133 999
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<br />ATTN: ELLL[-FKITZLBR, OPCR(XIO{~~!!~$
<br />NATIONAL POLLIRMT DIBCMMOE ELIMINATION 9rerEM lNPDESI Form Approved.
<br />OIBCHI R61E MONRORING REPORT IDM91 $ E D I P O ND ~ L T J NDM~MPRZR,~. A4PtS N
<br />CD'G 0024 Approv OS-31-98
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<br />PE ~ IT NUMBER DIS,CHNIGE aFnBER F - FINAL
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<br />' !70711 l77-731 ! ~.'{1 1;'{, -791 l363/I - NOTE: Rud 7rntFactlarrbefon aompMtMp this farm.
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<br />PARAMETER 13~dOn QUANTITY OR LOADING OnlYf• 9 ANFITY OR CONCENTRATION jiD. FREQUENCY SAMPLE
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER 1 cERnFr UNDER RENµTr of
<br />AM FAMILIM WITH THE INfO uw.TNAT I NAVE PERSONALLY EXM11
<br />TIppNN BUeM
<br />TTEO NEREIN
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<br />ASED ON • "-~..
<br />' TELEPHONE DATE
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<br />MY INQUIRY OF TNOBE IN0INUUKS IMMEDIATELY REBPONSIB LE FOR
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<br />' OBTAINING 7NE INFORMATON, I BMBVE THE SUBMITTED INFORM ATION 19
<br /> TRUE, ACCUMTE MD COMRQE. I AM AWME TNAT TNE
<br />SIONINCMT PENALTIES I'Oq 5UBMITTNO FALSE INFORMATON
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<br />Ke 1 1 Fritz 1 e r
<br />y , 97O 29-5855 99 { 0 2 {
<br /> THE POSSIBILITY OF NNE MD IMPWBONMENT. BEE 18 U.S.C. F 1001 AND J] EXEC
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<br />COMMENTS AND EAYLANATIVN OF ANY VIOLAIIVNS I/Tererence al/ettscnments Derv/
<br />SETPLBABLd SJLIJS LZ!fLl APPLIES ONLf IF C= 10-YR, 24-R6 PRECiP cYENT IS CLAIdED. IF CLAIM APPRD~ED B1
<br />YQCU, TSS S IRON LI`fIP3 YILL NOT BE APPLIED TJ AEPORtED lBASOBHlfENTS'-S H I.B.11, PG 5 AND L B.1D, PG 6.'
<br />S411N NY lTBR NAYS ,Pe FMT DT BY '{~$ 1 -1 -~{,~_ '.
<br />EPA.Fa/h 3320-1 108-95{ Previow edmone mey be used.
<br />x IREPLACE6 EPA FORM T-40 WMICN MAY NGT 6E U6ED.1
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