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PERMITTEE NAME/ADDRESS prrl. Frery Na./Incanw dDl~...q
<br />NAME CYO J'~ Y^."DA Y^LL-Y "~9L ^n?~,
<br />ADDRESST~I ~~.i Ir"J S'7J Ttl> r;C~~Ay ",r
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<br />FACILITY
<br />LOCATION
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<br />NATIONAL POLLUTMT DISCNMOE ELIMINATON 9VSTEM (/VPDf$l
<br />DISCHARGE MONITORING REPORT IDMRI
<br />l1-161 17-191
<br />PERMIT NUMBER DISCHMOE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAV YEAR MO DAY
<br />FROM ~ i TO ' +l
<br />110-111 /11-131 /1415/ 116171 l18-191 130-311
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<br />Form Approved.
<br />,~ ,OMBJNo,~2040-000¢.•v
<br />Approve e~piroe.05-31-98
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<br />PARAMETER 13 a.d Onlyl QUANTITY OR LOADING !4 and OnlT) QUANTITY OR CONCENTRATION NG FREQUENCY SAMPLE
<br /> 146531 154811 !38451 !06531 !5461/ of
<br />131-371
<br />AVERAGE
<br />MAXIMUM
<br />UNITS
<br />MINIMUM
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<br />UNITS EX
<br />l61-691 MµyyB
<br />Fe0-58/ TYPE
<br />163701
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<br /> MEASUREMENT
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED MD
<br />AM FAMIUM WITH THE INFORMATION SUBMITTED HEREIN: MD BASED ON TELEPHONE DATE
<br /> MY INQUIRY OF THOSE INDIVIDUN
<br />S IMMEDIATELY RESPONSIBLE FOR
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<br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS
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<br />EPA Form 3320-1 IOS-951 Prevloue edmanre mey ba used. /REPLACES EPA FORM T-40 WHICH MAY HOT BE USED.1 n ^? II ,T / o „ ~ II n -, _ T -~ ~ ~, PAGE t OF
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