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PERMITTEE NAME/ADDRESS (InNude Faciliry Name2ocanon ifDiBarenrl NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved.
<br />NAME ;, N r::: 4 .:DAL C J '; Y k'4 ( DISCZAR GE MONITORING REPORT (OMR~sI I x, ,J Y OMB No. 2040-0004
<br />Approval expires 05-31-98
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<br />i d1Y1769 CD 81639 PERMIT NUMBER DISCHAFiOE NOMBER P - FI irAL :'uJ I'L"
<br />DL S C 6i RGE TO B H A 5:i Y C d E L. K
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<br /> NAME(TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW TtlAT I HAVE PERSONALLY E%AMINED AND TELEPHONE DATE
<br /> AM FAMILIAR WITH THE INFORM ATION SUBMITTED HEREIN; AND eASED ON MY
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
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<br />EPA Form 3320.1 (OB-95) Previous editions may not be used. ~ (REPLACES EPA FORM T-00 WHICH MAY NOT BE USED.) 00 Do 3 / v 9 0 513- l la U PAGE I OF
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