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'-(ti 1 N SUBMITTED HEREIN; AND BASED ON <br />MY INQUIRY OF TNOSE INDINDUALSIMMEDIATELY RESPONSIBLE FOfl <br />OBTAINING THE INFORMATION, I eEUEVE THE SUBMITTED INFORMATON IS <br />TRUE <br />ACCUMTE AND COMRETE <br />1 a <br />AWARE T <br />AT T <br />E / <br />I i <br />; <br /> <br /> <br />~ <br />~~ <br /> <br />' <br />~ , <br />. - <br />H <br />H <br />RE ME <br />M <br />BIGNIHCANT PENALTIES FOR SUBMITTMG F/LLSE INFORMATION <br />INCLWING _ - <br />~ ~ ~ .1 ~~~~~" -~ `F~ - <br />~ <br />'7 <br />"/ <br />r <br />T <br />U <br />~ ~ <br />' <br />~ , <br />THE POSSIBILITY OF HNE ANO IMPRISONME <br />T <br />SEE <br />i -/ <br />l ~ <br />' , ~/ ~ I <br />' <br />l i( <br />I /.< <br />. +- L- <br />"J N <br />. <br />18 U.S.C. 1 t00 <br />AND 3G <br />BIONATUI <br />E / <br />/ ` <br />f I <br />_ _ <br />t - -J <br /> <br />R <br />T U.S.C. ! fJte. lMWb. wrWr drr mean. nrY MieAA. tors to ro 510.000 I <br />OF PIIINCIPAL EXECUTNE AREA <br />TYPED O <br />PRIN <br />ED eanrm..Ntrtr bev/emwm a/bwrn emmtlu e.le Frral OFFICER OR AUTt10RIZED AOENi CODE NUMBER YEAR MO DAY' <br />en euecnmenrs tiers/ <br />(~~ t. IuTAL [RLI~ L1N1T:, niLL ~c rIAIYLL;, ANL ~a_TTLL%.tLt ~~~L1J~ Litl[T •Sh('L1_:1 r:. r, 1UYr.F~4•':, Y'r,_:.;r c-Ic_;.(- <br />~L:- nL•k Ui: ~~ JF I'r L, LIF r:i ~~InIMtNTJ u~v~E: li I.w.3, P. C. 'J1L f. LIn;-4JL .]LL i.::. l.i,. 3u t,AY AVL k:: ,, ~_ ( , <br />. l i -. T M 7 v I. 1 t l t" <br />EPA Form 3320-1 106-96 Previous editions mey tis use IR CEB P FO M 4 ICN MAY NOT BE USED.1 V ~ U ~) / Y G V y i U -.. / ~ 4 PAGE 1 OF <br />