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<br />DISCHARGE MONITORING REPORT (OMR~ OMB No. 2040-0004
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<br />PARAMETER 3
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<br />UNRS ANALYSIS
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<br />NAMERITLE PRINCIPAL E7(ECUTNE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM LAW THAT 1 HAVE PERSO
<br />ATION SUBMITTED HERE NALLY EXAMINED AND
<br />IN; AND BASED ON MY TELEPHONE DATE
<br />~. INQUIRY OF THOSE INDMDUAL S IMMEDIATELY RESPON SIBLE FOR OBTAINING
<br /> THE iNFORMA710N, f BELIEV E 7HE SUBMnTED IN FORMATION !S TRUE,
<br /> ACCURATE AND COMPLETE.
<br />PENALTIES FOR SUBMITPN 1 ALI AWARE THAT TH
<br />G FALSE INFORMATIO ERE ARE SIGNIRCANT
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<br />INCWDING THE ~ '
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<br />.., ~~ POSSIBILITY OF FINE AND IMPRI SONMENT. SEE 18 U.S.C. 4 1001 AND 33 U.S.C.
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell attachmenGS here)
<br />FtFC i'.T "P:CT" (FC ChiCFI FF ^,pEF.T`I) IF r. C. :Y ICFIhE CSFI--: EE G/. C11 L CnEF'=F - I.E.I.C, FC. t. ~FTFIY
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<br />EPA.Form 3320.1 (0&95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED,) C C C C ~: / ~~ `a C i 1 f - 1 c_ i f PAGE _ OF
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