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<br />NATIONAL POLLUTAM DISCHARGE ELIMINATION SYSTEM MPDES) Form AppfOVed.
<br />DISCHARGE MONITORING REPORT (OMR; OMB No. 2040-0004
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WRH THE INFORM
<br />INOUIRV OF THOSE INDMDUAL
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<br />ATION SUBMITTED HEREIN; AND BASED ON MY i
<br />S IMMEDIATELY RESPONSIBLE FOR OBTAINING
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<br />E THE SUBMITTED INFORMATON IS TRUE DATE
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<br />::ichard A^,Ills
<br />ACCURATE AND COMPLETE. ~
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<br />I AM AWARE THAT THERE ARE SIGNIFICANT
<br />,- PENALTIES FOR SUBMITTIN
<br />,_rvironmental IJialiagcl- POSSIBILITY OF FINE AND IMPR G FALSE INFORMATION, INCLUDING THE g]Q 8']Q-2717.
<br />ISONMENT. SEE 1e U.S.C.41001 AND 33 U.S.C. SIGNATURE OF PRINCIPAL EXECUTIVE 6 ?4 99
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<br />TYPED OR PRINTED § 1318. IPornlties ands/ these s
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell attachments here)
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