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<br />PAOAIA CO 61423
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<br />LOCATION
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<br />'tll$CHARGE ~ONITgRIN'O REPpRT Id,T1R7
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<br />PERMI NUMBER OISCHMGE NUMBEA
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<br /> MEASUREMENT
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<br />NAMERTTIE IN A EXECIAlVE
<br />' 6FFI ER ~ CERT)FY uNDUI P~TIKTY OF lAW TNAT 1 HAVE PENSO
<br />''AM FAMIUM INITH THE INFORMATION BUeMITTEO H NKLY E%AMIN
<br />EgBN; MD •A ED'MD
<br />SED ON `
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<br />/ TELEPHON E DATE .
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<br />~` 111 rll M, ~~~/~ 1~ J IL. MY INAUIIIY AF THOSE INDINDUKB IMMEDIATELY RESPONSIBLE FOR
<br />OBTNNING THE INfORMATON, I eEUEVE THE SUBMITTED INFORMATION IS //
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<br />n 'TgUE, ACCUMTE MD COMRETE. I AM AWME THAI THERE ME
<br />51 NIFIDANT PENKTIES FOR SUBMITTING FKSE INFORMATION
<br />INCLIAING !
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<br />THE POSSIBILITY OF FlNE MPdMPIBSONMTIIT. SEE 18 U.S.C. 1 1001 MD Sa
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<br />5$TTLEA9LE SOLIDS LIlIIT..APPLIBS ORLT I'F C=10TA,248R PRECIP EYENT IS CLAIMED. I'i CLAIM APPROYF.D 3I :?CD,
<br />T~S E IROX LIMITS HILL #OT 9E APPLIED TO R£POATF.D IIEASUAEMEYTS-SEE I.'.T. PC 4, F7R iiOHDEti OF PA70°
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