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PERMITTEE NAME/ADDRE58 p~dr Frmy Nsr~loc,nu do~...,r/ NATIONAL POLLUTMT DISCHMOF ELIMINATION eYgTETt /INPDESf Farm Approved.
<br />NAME t.YPaUS LMV'Irit (. L,Ki'UKAT IUly DISCN?N6E MONITORING REPORT lOM91 era/h :Z Cif-iIa Ti;0AP91MP 7AOa~-0004~~
<br />Approve expjrppa ~~31-98
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<br />PARAMETER 13 Grd OnlYl QUANTITY OR LOADI !1 Grd On/yl QUANTITY OR CONCENTRATION ND ~REDUENCY SAMPLE
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<br /> AVERAGE MAXIMUM S MINIMUM AVERAGE MAXIMUM UNITS le2a.71 15I-6B1 769-701
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFr UNDER PENALTY OF LAW THAT NAVE PERSO xutr ExAMINFD~MD ~ TELEPHONE DATE
<br /> AM FAMIUM WITH THE INFORMATIONS BMITTED H EREIN: MD BASED ON
<br />OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION 19
<br />Ric!wrd MIDIS TRUE. ACCURwTE MO COMPLETE. 1 AM AWME tNAT.TNETtE ME
<br />SIONIFICMT PENALTIFB FOR eUBMITTIMO FALSE INFORMATION, INCLUDING n,
<br />Environmental 'Liana~er iNE POSSIBILITY OF RNE MDIMPRI80NMENT. SEE IB U.S.C.1 t00t MD3a - ~97gJfl7O-212 4 17
<br />u.s.C. f rate. rAUVe., uM.r eI,1I mnrt., m.r how. 9rN, W ro f x0,000 BIONATURE OF PRINCMAL EXECUTNE
<br />TYPED OR PRINTED ,M wmuMUn hlMamwnt ae.nr... enwlm, rwewral OFFICER OR AUTNORQED AGENT CODE NUMBER YEAR MO DAV
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS !Rs{~rencs d/eEEechmenta hrrel
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<br />EPA Form 3320.1 108.961 Previous editions mey bs used. (REPLACES EPA FORM T-40 WHICH MAY NOT SE U8ED.) U J 1 D b / y b I U:1 i ~ L ,i I I PAGE OF
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