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PERMITTEE NAME/ADDRESS Q,NlrLFs-01ryNsWfaalm UDdrr..,v) NATIONAL POLLUTANT DISCHMOE ELIMINATION 9YSfEM /NPDfSI Form Approved.
<br />NAME ~yf,xL~ YAP•!~A adLLt Y, t:,(jAl C~Ir,P. DISCH~R61E MONITORING REPORT (OM9I ~O~B q. 2~ ~DOQ4
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<br />PERMIT NUMBEa DISCHMQEriuIAeER
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<br /> NAMERITIE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF'L
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<br /> THE POSSIBILITY OF FNE AND I ,
<br />MPNSONMENT. SEE 18 U.S.C. 1 1001 AND 3J v BIONATURE OF PR
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<br />U.S.C. 1 1ST •. IM1rWeW uWr eww mNna my A%hM rw. ,y ro ! 10,000 INCMAL
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<br /> TYPED OR PRINTED radmuimn,Mpla+rMnf o/bMwn•menM. rll6y.va.! OFFICER OR ALJTNORRED AGENT CODE NUMBER YEAR MO DAY
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