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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) FORR Approved.
<br />DISCHARGE MONITORING REPORT (OMR~ OMB No. 2040-0004
<br />tz-rs1 I1'- v1 ! f N O ~ Approval expires OS-31-96
<br />PERMIT NUMBER DISCHARGE NUMBER
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<br />PARAMETER (46-53 (54L7 (3845) 46-53 54-81) EX OF TYPE
<br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS Arua.YSs
<br /> (6~T7 64-68) 6&70
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<br />NAMEJTITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILLAR WITH THE INFORM LAW THAT I HAVE PERSONALLY E7(AMINED AND
<br />ATION SUBMffTED HEREIN; AND BASED ON MV TELEPHONE DATE
<br />~ r ~ ~ ~ j ~ ~ Ali INQUIRY OF THOSE INDIVIDUAL
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<br />PENALTIES FOR SUBMITTIN IPM AWARE THAT THERE ME SIGNIFICAM
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<br />-POSSIBILITY OF FINE AND IMPRISONMENT. SEE 1S U.S.C. § 1001 AND 33 U.S.C.
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<br />NUMBER
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all etfachmen4s here) -
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<br />P ~~r 3~ Prevl I)5 editiori4 May rio'be Setl' • `-• (RE CES'~A F" h T ~~ I O E ED:) ~ -'- • PAGE OF
<br />UO]Q7/~~gi17-127? 1
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