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<br />NATIONAL POLLVTANT DISCMMOE ELIMINATON aYBTEM /NPDESI Form Approved.
<br />DISCHARGE MONITORING REPORT !O RI ` / ~ +~ ) I T ~, 0l~g~No.12040-0004 .
<br />S•16 17-191 ~~v~n
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<br />NAME7TITLE PRINCIPAL EXECUTIVE OFFICER I CERT
<br />AM FA FV UNDER PENALTY OF LAW THAT 1 HAVE PERSONALLY E%AMIN
<br />MIDAR W17H THE INFORMATION SUBMITTED HEREIN; AND BA ED AND
<br />9ED ON TELEPHONE DATE
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<br /> MY INQUIRY OF THOSE INDINDUALS IMMET)IATELY RESPONSIB
<br />OBTNNINO THE IHF011MATION
<br />1 eFDEVE THE SUBMITTED INFORMA LE FOR
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<br />TRUE, ACCUMTE AND OOM0.ETE. I AM AWARE TNAT THE
<br />SIONIFCANT PENALTIES FOR eUBMfTTiNO fA19E INFORMATION
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<br />Environmental fdana E!C ,
<br />iNE POSSIBILITY OF RNE AND IMP11130NMENT. SEE to U.S.C.11001 µD3]
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