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PERMITTEE NAME/ADDRESS ..•~~'fi~ryNamdGocafioni Dr eraq).. •..+'~ . ~ ~ ~'-~sl ,`?~:,••.,' . ... , .,. ~. ~ ~ ~ .
<br />~^cludc ~dc! 16~ ,. ;Yh~; "`•~~nTIONAL POLLVTANTOISCHARG ELIMINATION SYSTEM (NPDES) ~ pofmApproved.-
<br />NAME ~ ~ --r.,r?. r ... DISCHARGE MONITORING REPORT (OMR) OMB No.2040-0004
<br />TRAPPLR..tfINiNGj INC. !IINOR
<br />ADDRESSx$~QjRER ,!{IN£ ~ ~ ~ (~SUBR NN)
<br />P.¢..:.;BOY '~,87 PEAMIT.NUMBER OISCHARGENUM9ER R _ FINAL t70PAT
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<br />NAME/TITLEfRINCIPAL EXECUTIVE OFFICER ICertiry undarpenalry of law that lM's documerrl antlall atlathments were -
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<br />. praparetl under my tlireclion or supervision in ac6ordance wjVr 93yst d
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<br />W. Gordon ;Peters ioassurathat qU-shed-personae pr p gelher and evalu4la the lnlorrpalion
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<br />Presidegt/General Manager ,
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<br /> submitted ls,to lhobestormylmrnvledge antl belle/, [rua, ac4Urala, Bnd cgmpl9
<br />e. SIGNATURE OF PRINCIPAL EXECUTIVE -
<br />[IEDORPRINTED
<br />"Ti( lam awerethatthera am signiRrarM pgna(ties for wbmininglalse lntamation, '
<br />ipclutling ttia poseibiliry of line endimprisonmerrtlor knowing violatbns: OFFICER OR AUTHORIZED AGENT
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<br />NUMBER
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<br />MO
<br />DAY
<br />^OMMENTS ANDFJ(PtJiNAT10N.OFRNY VIOLATIONS (Reference all attachments here)
<br />.+6E i.A:2,~ F~.7-9. PUA D.ExdILS.OF resx PROCEDURE. REPORT LC50 - STATISTICAL POSNT ESTIMATE, linIQH IS '
<br />1.t:THAL '(0•:507{` OP TEST DR~ANIS<!5• AND AYTACk dCOTE TOYICITT TEST REPORT FORlS TD DlIR. COP2E5 0^ ALL
<br />~ form V• ~ Previous a itions may be us .' • ~ V ~~ I c ^
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