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PERMITTEE NAME/ADDRESS (include F'aciliry Nmne/Locmitn JD fferenlJ
<br />NAME :~::H::~A Clil,L ;:Ot;P6NT
<br />ADDRESSD H n a ~ kf D
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<br />CD tl1o33
<br />FACILITY
<br />LOCATIOI'l1AYUdh CD Blhl~
<br />ATfa: ~.. 9J0 h40.IN, GiYcH:L l1ANAOEn
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOESJ
<br />DISCHARGE MONITORING REPORT (DMR;
<br />ccJCOUZZI oou a
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM TO y I~ `~ ~ `'
<br />(2421) ~~ (Q2-231 (29-25) (2G2rJ (28-29) (3031)
<br />Forth Approved.
<br />-, I _ .. OMB No. 2040-0004
<br />Approval expires OS-31-98
<br />F' - FINAL n,JUTi
<br />DISCHARGE 'rU THIH/FLAN C11r.cK
<br />%~'p NO DISCHAHLE (~~ rn+'
<br />NOTE: ~flead Instructions before completing this loan.
<br /> (3 Cerd Ony) QUANTITY OR LOADING (4 Cecil Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (46.53) (54-81) (3Bd5) (46-53) (54-61) EX OF TYPE
<br />(32-3n AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />(52x3) ANALYSIS
<br />(64-69)
<br />69-70
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<br />NAME/TITLE PRINCIPAL EXECIJTNE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO NALLY E%AMINED AND
<br />TELEPHONE DATE
<br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HER EIN; AND BASED ON MY
<br />A 5 Sc M aC INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPON
<br />QhA ~ V THE INFORMATION, I BELIEVE THE SUBMITTED IN SIBLE FOR OBTAINING
<br />FORMATION IS TRUE,
<br />ACCURATE AND COMPLETE. I AM AWAFE THAT TH
<br />PENALTIES FOR SUBMnTNG FALSE INFORMATIO
<br />w S ~ = POSSIBILITY OF FINE AND IMPRISONMENT. SEE 1B U.S.C
<br />' ERE ARE SIGNIFICANT
<br />N, INCLUDING THE C
<br />. § 1001 ANO 33 U.S.C. SIGNATURE OF P NCIPAL EXECIlTNE 5.1
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<br />TYPE OR PRINTED es under mesa statures may Intrude fines up ro 510,000 end a
<br />S 1319. (Penele
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<br />NUMBER
<br />YEAR
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relevance ell attachments here)
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<br />EPA Form 3320.7 (OB-98) Previous editions rnay~not be used. -~ + ' ~(XiE~U1~ES EPI( CORM T-a0 WHICH MAY NO7 BE USED.) OOOO 5 / 9 3 U S 1 3-11 U U PAGE 1 OF
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